- Baylor Scott & White Health (Honolulu, HI)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- 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)
- …and Sunday required in addition to 3 weekdays** This job implements 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
- Guardian Life (Honolulu, HI)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… 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
- 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