- Highmark Health (Honolulu, HI)
- …any combination of clinical, case management and/or disease/condition management experience, provider operations and / or health insurance experience ... health status/severity and clinical needs. The incumbent assesses health management needs of the assigned member...of members in his/her panel that are enrolled in case management . The incumbent conducts outreach to… more
- Highmark Health (Honolulu, HI)
- …of clinical, case /utilization management and/or disease/condition management experience, or provider operations and/or health insurance experience ... **JOB SUMMARY** This job implements effective complimentary utilization and case management strategies for an assigned member... health status/severity and clinical needs; and assesses health management needs of the assigned member… more
- Highmark Health (Honolulu, HI)
- …and timely processing of pre-certification requests for authorization of medically necessary health care services at the appropriate level of care, based on the ... information, and decision timeframes. Follow policies and procedures to assure case completion and compliance with state and federal regulatory agencies. Maintain… more
- Magellan Health Services (Schofield Barracks, HI)
- …Participate in relevant community awareness, campaigns and prevention events. + Maintain ongoing case management , all data entry must be completed within three ... school in social/work, psychology, marriage, family, and child counseling, counseling or behavioral science, education, community health or public health .… more
- Highmark Health (Honolulu, HI)
- …required based on business need. **Preferred** + None **SKILLS** + Critical Thinking + Case Management + Customer Service + Oral & Written Communication Skills + ... the incumbent participates as the physician member of the multidisciplinary team for case and disease management . They will advise the multidisciplinary team on… more
- US Marine Corps (Kaneohe, HI)
- …assessment, evidence-based and informed interventions, service planning, and clinical case management services. Comprehensive non-medical counseling services ... assessments, safety plans, clinical counseling notes, individualized service plans, clinical case management , collateral notes, contact details, and other… more
- Defense Health Agency (Honolulu, HI)
- …the GS-12 grade level in the Federal Service which includes 1) Developing Behavioral Health treatment plans; 2) Administering psychological tests or assessments ... our growing team! AtTripler,you will practice alongside civilian and military health care experts and experience unique professional opportunities. Our staff serves… more
- Highmark Health (Honolulu, HI)
- …by the Standards of Ethical Coding as set forth by the American Health Information Management Association and Corporate Compliance Coding Guidelines. Assures ... works with external resources to create and monitor inpatient case mix reports and the top 25 assigned DRGs/APCs...from American Academy of Professional Coders (AAPC) or American Health Information Management Association (AHIMA) + AHIMA… more
- Highmark Health (Honolulu, HI)
- **Company :** Highmark Inc. **Job Description :** **JOB SUMMARY** HNAS ( Health Now Administrative Services) offers flexible, cost-effective solutions for employee ... health benefits. HNAS is part of Highmark Health...a contributor to the divisional planning process and senior management team. Responsible for managing the identification of enhancements… more
- Highmark Health (Honolulu, HI)
- …in lieu of Bachelor's degree **Preferred** + Master's Degree in Business Administration/ Management or Mental Health Services **EXPERIENCE** **Required** + 7 - ... Highmark Inc. **Job Description :** **JOB SUMMARY** This job provides end-to-end management , delivery and support to new and existing Risk Adjustment Programs. The… more
- Highmark Health (Honolulu, HI)
- …sales objectives. The incumbent is responsible for consulting with all levels of management to proactively identify and develop a win strategy that communicates and ... project plans within tight deadlines that require cross-functional collaboration and management of interdependencies and/or related activity within the constraint of… more
- Humana (Honolulu, HI)
- …our caring community and help us put health first** The Senior Utilization Management Behavioral Health Professional utilizes behavioral health ... medical services and/or benefit administration determinations. The Senior Utilization Management Behavioral Health Professional work.... Experience in utilization management review and case management in a health … more
- Highmark Health (Honolulu, HI)
- …SUMMARY** Work with Pharmacy Markets business owners, stakeholders and other management , as required, to achieve Pharmacy Markets growth objectives. Organize and ... to understand business needs, processes project specifications and business case development. Translate business needs into clearly defined and documented,… more
- BAYADA Home Health Care (Waipahu, HI)
- …for RBTs + Supervise a team of BCBAs, including report reviews, onsite case consults, ongoing training, and group meetings + Collaborate with Director of Clinical ... Operations and Manager of Behavioral Operations to ensure clinical quality and ethical compliance...hours, flexible work schedule, opportunities to develop leadership and management skills. + BAYADA offers a comprehensive benefits plan… more
- Highmark Health (Honolulu, HI)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Billing Product Manager defines and executes the strategy and roadmap for a best-in-class ... define the product's value proposition to develop a compelling business case focused on revenue generation and operational efficiency. Responsibilities include… more
- Highmark Health (Honolulu, HI)
- **Company :** Highmark Health **Job Description :** **JOB SUMMARY** The Customer Navigation and Service Senior Product Manager defines the vision, strategy and ... Manager will define the product's value proposition, develop a compelling business case , secure buy-in from key stakeholders, and drive execution to deliver… more
- US Marine Corps (Kaneohe, HI)
- …development, aid in child abuse prevention and promote good overall mental health . Conducts clinical assessments of families and children receiving services and ... Marine Corps New Parent Support Program (NPSP) program. Maintains individual case records IAW with prescribed regulations and ensures confidentiality and security… more
- Otsuka America Pharmaceutical Inc. (Honolulu, HI)
- …in the prediction, prevention, and management of conditions related to women's health , the mental and behavioral spaces, and overall well-being. This is an ... Otsuka Precision Health is a health experience company...core element of this team, with responsibilities spanning product management and product development in key priority areas. Working… more