- Elevance Health (Kapolei, HI)
- …prior utilization management, medical management and/or quality management, and/or call center experience; or any combination of education and experience, which ... for payment as part of consideration for employment. **Nurse Reviewer I** + Job Family: MED > Licensed Nurse...plans strongly preferred. + BA/BS degree preferred. + Previous utilization and/or quality management and/or call center… more
- Evolent Health (Honolulu, HI)
- … utilization and compliance with SBU`s policies/procedures, as well as Utilization Review Accreditation Commission (URAC) and National Committee for Quality ... **What You'll Be Doing:** As a Cardiology, Physician Clinical Reviewer you will be a key member of the... you will be a key member of the utilization management team. We can offer you a meaningful… more
- Evolent Health (Honolulu, HI)
- …the mission. Stay for the culture. **What You'll Be Doing:** To ensure the appropriate utilization of services act as an advocate for our members and to ensure the ... care. **Collaboration Opportunities:** As a UR Nurse in the Utilization Management department, you will work closely with other...medical necessity, the request is sent to a physician reviewer . At no time can a URN recommend an… more
- Humana (Honolulu, HI)
- …health insurance, other healthcare providers, clinical group practice management. + Utilization management experience in a medical management review ... with prior experience participating in teams focusing on quality management, utilization management, case management, discharge planning and/or home health or post… more
- Always Best Care Senior Services (Honolulu, HI)
- …or services (with complete cost/benefit analysis). Oversees all CQI and utilization review activities. Assists in agency evaluation activities. Participates ... care facilities regarding staffing needs. Evaluates own job performance and utilization of resources in planning for professional growth. Participates in state… more
- Ankura (HI)
- …applications. + Monitor cloud infrastructure performance, availability, and capacity utilization using monitoring tools like CloudWatch, Azure Monitor, or ... Gather facts and data to be used in the review of proposals which consist of objectives, scope, and...reference and knowledge sharing. + Participate in regular on call work, as part of an on- call … more
- Transdev (Pearl City, HI)
- …reports + Create various utilization and reconciliation reports monthly + Assist with call queues when necessary to ensure service levels are met + Adhere to and ... to travel inter-island or out of state + Obtain, review , and approve required medical documentation authorizing long distance...pass a drug screen and background check. Job Category: Call Center / Dispatch / Reservationist / Scheduler Job… more
- Lincoln Financial Group (Honolulu, HI)
- …potential group insurance product (example: dental, life, disability, FMLA, etc.) in a call center environment. You will act as a liaison between the employee ... questions and providing information regarding their claim through the utilization of multiple applications and platforms. In addition, you...in a career at Lincoln, we encourage you to review our current openings and apply on our website.… more
- General Motors (Honolulu, HI)
- …+ Conduct user training and provide ongoing support to ensure effective utilization of Adaptive Planning by end-users. + Drive process improvements and best ... an equal opportunity employer. We encourage interested candidates to review the key responsibilities and qualifications and apply for...or application for employment, email us at ###@GM.com or call us at ###. In your email, please include… more
- CVS Health (Honolulu, HI)
- …and calling prescribers for prescription renewals, prescription clarifications and drug utilization review questions 3. Researching and resolving prescription ... through ###@CVSHealth.com If you have a speech or hearing disability, please call 7-1-1 to utilize Telecommunications Relay Services (TRS). We will make every… more