- Humana (Honolulu, HI)
- …and help us put health first** Full-Time Remote, Telephonic RN opportunity. The Utilization Management Behavioral Health Nurse utilizes behavioral ... years of clinical and Utilization Management experience. The Utilization Management Behavioral Health Nurse completes medical record reviews from… more
- Humana (Honolulu, HI)
- …community and help us put health first** Humana Healthy Horizons is seeking a Utilization Management Behavioral Health Professional 2 who utilizes ... and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Professional… more
- Lincoln Financial Group (Honolulu, HI)
- …including 1 year in claims, disability management (STD/LTD), worker's compensation, utilization review, and or behavioral health case management ... **The Role at a Glance** We are excited to bring on a knowledgeable and motivated Behavioral Health Consultant to our Clinical Organization to work in one of our… more
- Humana (Honolulu, HI)
- …teams focusing on quality management , utilization management , case management , discharge planning and/or home health or post acute services such as ... part of our caring community and help us put health first** The Behavioral Health ...health insurance, other healthcare providers, clinical group practice management . + Utilization management experience… more
- Highmark Health (Honolulu, HI)
- …account, and member educational initiatives that promote the Organization's Formularies, utilization management programs, and case/ disease management ... information to improve individual outcomes as an adjunct to health coaching. If acting in the capacity as a...review. + Assist in the development and implementation of utilization management programs including but not limited… more
- Highmark Health (Honolulu, HI)
- …for the patient, and then creates the case (data entry) in Highmark's utilization management system for clinical review. Ensures all accurate information is ... including verification of benefit eligibility. Build cases in the utilization management system. + Use knowledge of...0 - 1 year of experience working in the Health Insurance Industry **LICENSES AND CERTIFICATIONS** **Required** + None… more
- Humana (Honolulu, HI)
- …experience leading teams focusing on quality management , utilization management , discharge planning and/or home health or rehab. + Strategic thinking ... the senior population with a strong lens on intersecting behavioral and social health needs. + Provide...management , utilization management , case management , discharge planning and/or home health or… more
- Elevance Health (Kapolei, HI)
- …evaluation, coordination and management of member's needs, including physical health , behavioral health , social services and community services ... the health care team, to ensure cost effective and efficient utilization of health benefits. + Decision making skills will be based upon the current needs… more
- Highmark Health (Honolulu, HI)
- …contribute to highest levels of performance. **ESSENTIAL RESPONSIBILITIES** + Perform management responsibilities including, but limited to: involved in hiring and ... termination decisions, coaching and development, rewards and recognition, performance management and staff productivity.Plan, organize, staff, direct, and control… more
- Highmark Health (Honolulu, HI)
- …with the Software Lifecycle + 3 years of Advanced domain experience **Preferred** + Utilization Management product experience highly preferred + 3 years with the ... + Business Acumen for P&Ls + Communication + Conflict Management **Language (Other than English):** None **Travel Requirement:** 0%...job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of… more
- Humana (Honolulu, HI)
- …+ Administer new innovative VBP models for range of provider types, such as behavioral health , maternity, specialists, and social determinants of health , ... **Become a part of our caring community and help us put health first** The Sr. Value-Based Programs professional supports successful value-based provider… more
- Centerwell (Honolulu, HI)
- …that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more ... leader will play a critical role in ensuring optimal patient care, high quality health outcomes, and improved cost and utilization in pharmacy-related care, and… more
- Marriott (Honolulu, HI)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** Marriott has an exciting opportunity for a ... + Experience in waterfall and/or agile software methodologies + Vendor management experience **Preferred Qualifications:** + Graduate degree + Oracle Global Human… more
- Humana (Honolulu, HI)
- …opportunities which may support Member Engagement, Clinical Performance, Provider Engagement, Behavioral Health and Pharmacy. + Exercises considerable latitude ... of key utilization and financial performance measures related to Population Health ) + Proficiency in verbal and written communication to senior and executive… more
- Marriott (Honolulu, HI)
- …States **Schedule** Full-Time **Located Remotely?** Y **Relocation?** N **Position Type** Management **JOB SUMMARY** The Senior Director, Brand & Marketing, will ... maintain marketing calendar and budget, supervise content creation; + Agency Management : manage one or more agencies overseeing the website, branded content,… more
- Humana (Honolulu, HI)
- …of clinical conditions and disease states, such as oncology, falls, palliative care, behavioral health and other chronic conditions + Deep understanding of ... part of our caring community and help us put health first** Humana's Clinical Strategy and Analytics (CS&A) Team...other specific healthcare areas such as EMR, Episode grouper, utilization management , value-based care, low value care… more