- Fresenius Medical Center (Honolulu, HI)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Highmark Health (Honolulu, HI)
- …Inc. **Job Description :** **JOB SUMMARY** This job implements the effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES:** + Implement care management review processes that are consistent with established… more
- Humana (Honolulu, HI)
- …hoc reports in Access and/or SQL + Graduate degree + Utilization Management Review Experience + Registered Nurse ( RN ) Credentials + Home Health, ... Durable Medical Equipment, and/or Skilled Nursing Facility Experience **Additional Information** **Scheduled Weekly Hours** 40 **Pay Range** The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week)… more
- Lincoln Financial Group (Honolulu, HI)
- …Experience and/or proficiency with Disability Management (STD/LTD) knowledge, Workers Compensation, Utilization Review and/or nurse case management ... will provide coaching and guidance to claims regarding medical management **What you'll be doing** * Evaluate medical information...looking for** * 4 Year/Bachelor's Degree in Nursing * Registered Nurse License - Current, unrestricted license… more
- Always Best Care Senior Services (Honolulu, HI)
- …which may be discussed with all management staff. QUALIFICATIONS 1. A Registered Nurse licensed in the state of Hawaii 2. Preferably, the coordinator ... or services (with complete cost/benefit analysis). Oversees all CQI and utilization review activities. Assists in agency evaluation activities. Participates… more
- Fresenius Medical Center (Honolulu, HI)
- …related field preferred or an equivalent combination of education and experience Registered Nurse required Certification in Nephrology Nursing or quality ... barriers to quality improvement. This includes promoting the adoption and utilization of Corporate Medical Advisory Board Recommended Algorithms and Standing Orders,… more
- Hawaii Pacific Health (Aiea, HI)
- …Starting Hourly Rate: 56.76 **Exempt:** Yes **Minimum qualifications:** Current Hawai'i Registered Nurse License. Bachelor's degree and/or equivalent combination ... (CDI) certification. Experience with InterQual, Milliman or other nationally recognized Utilization Management criteria. Experience with DRGs or inpatient… more
- Sharecare, Inc. (Honolulu, HI)
- …of the care enhancement program by providing telephonic care and resource utilization for members in an appropriate, efficient, and cost-effective manner while ... members of the health care team to support appropriate total healthcare management . RD colleague is supervised by an Operations Manager. All Sharecare clinicians… more
- Always Best Care Senior Services (Honolulu, HI)
- …are met. Additional responsibilities: * Develops a process to monitor appropriate utilization of services. * Directs the implementation of service goals and ... provides leadership in peak periods * Monitors clinical record review process. Case coordination oversight. * Develops plan for...a Medicare Home Health environment, hold a current APRN, RN license in the state of employment, and have… more