- Humana (Honolulu, HI)
- …Manager, Fraud and Waste Investigator: Nurse Audit/ Review performs clinical audit/validation processes to ensure that medical record documentation and ... approach, resources, schedules and goals. The Manager, Fraud and Waste Investigator: Nurse Audit/ Review validates and interprets medical documentation to… more
- Humana (Honolulu, HI)
- …in preparation of cases prior to review by the Humana G&A Medicare Medical Directors. The Nurse reviews the medical documentation, researching claims, ... and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to...Medical Directors on submitted G&A cases. The G&A Nurse will participate in initiatives which result in improved… more
- Humana (Honolulu, HI)
- …and help us put health first** The Nurse Auditor 2 performs clinical audit/validation processes to ensure that medical record documentation and diagnosis ... independent determination of the appropriate courses of action. The Nurse Auditor 2 validates and interprets medical ...coding experience to conduct a clinical validation review of the inpatient medical record to… more
- Datavant (Honolulu, HI)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- BAYADA Home Health Care (Honolulu, HI)
- **BAYADA Home Health Care** is currently seeking a **full-time Clinical Manager (RN required)** in our Medicare certified **Oahu Visits office in Honolulu, Hawaii** ... . As one of the Clinical Managers, you will lead the field staff in...hire onboarding and orientation of field staff + Documentation review , including OASIS and Home Care Home Base (HCHB)… more
- Highmark Health (Honolulu, HI)
- …over a specified panel of members that range in health status/severity and clinical needs; and assesses health management needs of the assigned member panel and ... utilizing data/analytics in conjunction with professional clinical judgement to identify the right clinical intervention for each member. The incumbent conducts… more
- Cardinal Health (Honolulu, HI)
- …to ensure a positive and satisfactory experience for all customers. The Supervisor, Clinical Operations monitors nurse to patient contact quality and provides ... manufacturers to rethink the reach and impact of their products. The Supervisor, Clinical Operations provides management and clinical oversight to a team of… more
- Fujifilm (Honolulu, HI)
- **Position Overview** The Clinical Consultant, MI - I shall be responsible for providing clinical consulting for the project, report configuration (CV), workflow ... go-live support to Synapse PACS/MI projects. In addition, provide clinical support for sales and company team members with...HCUS team to gain customer acceptance of the FUJIFILM Medical Systems solution. + Participates in teaching and training… more
- Centene Corporation (Honolulu, HI)
- …experience. Utilization Management experience strongly preferred.** **Position Purpose:** Performs a clinical review and assesses care related to mental health ... changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services...state required. Master's degree for behavioral health clinicians required. Clinical knowledge and ability to review and/or… more
- Queen's Health System (Honolulu, HI)
- …* Responsible for assisting in the overall quality and completeness of clinical documentation throughout The Queen's Health Systems, through concurrent medical ... reviews and query process. * Responsible for the concurrent review of provider documentation to ensure the appropriate capture...of patient care teams to ensure the integrity of medical record documentation and allow for accurate and complete… more
- Queen's Health System (Honolulu, HI)
- …activities in accordance with department's goals and objectives and mission of The Queen's Medical Center (QMC) and The Queen's Health Systems (QHS). * Serves as a ... resource for medical staff and medical center departments in...credentialing agencies, etc. * Coordinates, implements and facilitates key clinical performance improvement efforts including, but not limited to:… more
- Queen's Health System (Honolulu, HI)
- …process for oncology patients. * Serves as an advocate, interpreter, educator and clinical resource with expertise in medical , surgical, and radiation oncology ... RESPONSIBILITIES Review Date: 07/23 Effective Date: 08/20 I. JOB...LICENSURE: * Current Hawaii State License as a Registered Nurse . * Bachelor's degree in Nursing. * Certification in… more
- Fresenius Medical Center (Waipahu, HI)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with FMCNA policies, procedures, and training and in compliance ... last treatment. Report any complaints or observations to the nurse supervisor. + Evaluate vascular access for patency and...activities. + Enter all treatment data into the designated clinical application accurately and in a timely manner. +… more
- Zurich NA (Honolulu, HI)
- Sr Supplier Medical Process Specialist 128416 Zurich North America is seeking am experienced Sr. Supplier Medical Process Specialist to join our team in one of ... commitment to work/life balance, and outstanding culture. As a Sr. Supplier Medical Process Specialist, you will manage supplier performance and work product in… more
- Fresenius Medical Center (Ewa Beach, HI)
- …dialysis therapy for patients under the direct supervision of a licensed nurse in accordance with organization policies, procedures, and training and in compliance ... and/or change in patient condition directly to the registered nurse or supervisor. + Observe patient and conduct machine...activities. + Enters all treatment data into the designated clinical application in an accurate and timely manner. +… more
- Datavant (Honolulu, HI)
- …Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity and necessity of continued ... necessity criteria and standards of care, along with clinical knowledge and expertise successfully. Ideal candidate should be...to author appeal letter Identification of referrals to the medical director for review + Select appropriate… more
- Queen's Health System (Honolulu, HI)
- …education and patient care programs in advanced heart failure. * Serves as a clinical resource to patients, Medical Center staff and the community in advanced ... RESPONSIBILITIES Review date: 02/24 Effective Date: 10/20 I. JOB...heart failure care management and medical and surgical therapies. * Collaborates with all members… more
- Ethos Veterinary Health (Honolulu, HI)
- …of the Emergency Concierge is to provide a communication bridge between the ER clinical team and the front desk, ensuring that the clients understand where they are ... than anticipated/communicate "what to expect" with the owners + Review invoices prior to discharge, making sure that all...and go over euthanasia paperwork with owners + After medical update for inpatients have been given, go over… more
- Defense Health Agency (Honolulu, HI)
- **Overview** The position Physician (Occupational Medicine) is located at Tripler Medical Center, Honolulu, HI. The Island of Oahu in Hawaii is often nicknamed (or ... Tuberculosis Infection (LTBI) Clinic patients, and traditional Preventive Medicine: 1. Medical Case Management Responsibilities - Assesses the health care needs and… more
- Queen's Health System (Honolulu, HI)
- …or certificate as a Nurse Aide. o Diploma or certificate as a Medical Assistant. o Diploma or certificate as an Emergency Medical Technician. o Diploma ... RESPONSIBILITIES Review Date: 12/24 Effective Date: 04/21 I. JOB...assembly. * Performs duties in accordance with departmental and Medical Center policies, procedures and regulations. II. TYPICAL PHYSICAL… more