- Highmark Health (Honolulu, HI)
- …the effective utilization management strategies including: review of appropriateness of health care services, application of criteria to assure appropriate ... of quality issues. Monitors and analyzes the delivery of health care services; educates providers and members...established industry and corporate standards and are within the care manager 's professional discipline. Effectively function in… more
- Magellan Health Services (Honolulu, HI)
- …in healthcare, behavioral health , psychiatric and/or substance abuse health care setting. Strong organization, time management and communication skills. ... and analyzes utilization data. Assists with discharge planning and care coordination. Provides member assistance with mental health...Maintains an active work load in accordance with National Care Manager performance standards. + Works with… more
- Highmark Health (Honolulu, HI)
- …Requirement_** _: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company ... times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice… more
- Highmark Health (Honolulu, HI)
- …, identify resources, and conduct a number of other activities to help improve the health outcomes of members; care plans include both long and short term goals ... ownership and oversight over a specified panel of members that range in health status/severity and clinical needs. The incumbent assesses health management needs… more
- Highmark Health (Honolulu, HI)
- …relationship management and performance + Experience in Indirect Category Sourcing and/or Health Care Sourcing with demonstrated expertise in influencing the ... **Company :** Highmark Health **Job Description :** **JOB SUMMARY** This job...Certified Professional in Supply Management (CPSM) + Certified Purchasing Manager (CPM) **SKILLS** + Experience in strategic management and… more
- Somatus (Honolulu, HI)
- …the appropriate resources within the parameters of established contracts and patients' health plan benefits. Facilitates continuum of patients' care utilizing ... patients and families. + Assist member to maximize benefits according to health plan. + Participates actively in assigned Care Management Coordination… more
- J&J Family of Companies (Honolulu, HI)
- Johnson & Johnson is recruiting for a field-based Site Activation CAR-T Senior Manager , Cell Therapy Experience Lead to support the United States. This is a field ... close proximity to a major metropolitan airport. At Johnson & Johnson, we believe health is everything. Our strength in healthcare innovation empowers us to build a… more
- Sharecare (Honolulu, HI)
- …coordinates with the Primary Care Provider and all other members of the health care team to support appropriate total healthcare management and ensure cost ... in the appropriate stratification level. + Identifies participant barriers to accessing health care services. Coordinates with Provider Service Managers and/or… more
- Highmark Health (Honolulu, HI)
- …in special committee meetings as required. + Cooperates with other health care team members and the Operations Manager pursuant to the Allegheny ... timely manner. + Patients are appropriately referred to other health care support systems or community resources...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Evolent (Honolulu, HI)
- …Working across specialties and primary care , we seek to connect the pieces of fragmented health care system and ensure people get the same level of care ... medical reviews: LVNs, LPNs, and RNs along with our behavioral health reviewers: LMSWs, LCSW, and LPCs,...either requesting or submitting prior authorization requests. Or relevant health care experience in claims or appeal… more
- CenterWell (Honolulu, HI)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- Fresenius Medical Center (Honolulu, HI)
- …Human Behavior and accepted methods of social work practice. Works with the health care team to promote positive adjustment, rehabilitation and improved quality ... and supports staff in understanding the emotional, psychological and behavioral impact of Chronic Kidney Disease on the patient...affect adherence to treatment. Works with patient, family and health care team to provide education tailored… more
- CenterWell (Honolulu, HI)
- …impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... time with patients, providing compassionate, personalized care that brings better health outcomes. We...care , one of the largest providers of home health services, and fourth largest pharmacy benefit manager… more
- The Cigna Group (Honolulu, HI)
- …several health -related benefits including medical, vision, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, ... **Account Management (Non-IC) Lead Associate** The Account Manager is responsible for ensuring Accredo's customers, inclusive...Services, a division of The Cigna Group, creates pharmacy, care and benefit solutions to improve health … more