- Humana (Honolulu, HI)
- **Become a part of our caring community and help us put health first** The Utilization Management Nurse 2 utilizes clinical nursing skills to support the ... communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work...skills to make an impact** **Required Qualifications** + Licensed Registered Nurse ( RN ) in the… more
- Cognizant (Honolulu, HI)
- …have to be considered** . Educational background - Registered Nurse ( RN ) . 2-3 years combined clinical and/or utilization management experience with ... Eastern Time **Location:** Remote **About the role** As a Registered Nurse you will make an impact...care revenue cycle or clinic operations . Experience in utilization management to include Clinical Appeals and… more
- CenterWell (Honolulu, HI)
- …clinical experience. + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Intelligence + ... put health first** Conviva Care Solutions is seeking a RN who will collaborate with other health care givers...Experience with Home Health preferred + Previous experience in utilization management within Insurance industry a plus… more
- Centene Corporation (Honolulu, HI)
- …including a fresh perspective on workplace flexibility. Remote Position. Must Reside in Hawaii Registered Nurse ( RN ) or Licensed Clinician Only. Must have a ... license **Must have Behavioral Health and Substance Abuse experience. Utilization Management experience strongly preferred.** **Position Purpose:**...+ Licensed Mental Health Professional (LMHP) required or + RN - Registered Nurse -… more
- Queen's Health System (Honolulu, HI)
- …patients' needs in accordance with the principles and practices of a registered nurse . Knowledgeable in community health nursing and rehabilitation concepts. ... Other key responsibilities include patient/family education, utilization management , and coordination of care and...AND LICENSURE: * Current Hawaii State license as a Registered Nurse . * Associate's or bachelor's degree… more
- Hawaii Pacific Health (Honolulu, HI)
- …organizations and other combinations of medical, financial or social interventions. As the Registered Nurse Case Manager, you would ensure the considerate and ... 159,619 USD per year **Category:** Nursing **Minimum Qualifications:** Current Hawai'i Registered Nurse license. Bachelor's degree and/or equivalent combination… more
- CVS Health (Honolulu, HI)
- …is subject to change based on business needs. **Preferred Qualifications** 6+ months Case Management or Utilization Management experience Case Management ... however, it is subject to change based on business needs.** The RN Case Manager is responsible for telephonically assessing, planning, implementing, and coordinating… more
- Hawaii Pacific Health (Lihue, HI)
- …long term care, or related field. **Preferred Qualifications:** Current Case Management or Utilization Management certification. EOE/AA/Disabled/Vets Hawai'i ... and programs, including cardiology, emergency, family practice, gastroenterology, health management , internal medicine, neurology, OB-GYN, oncology, orthopedics, pediatrics and… more
- Queen's Health System (Kamuela, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. **II. TYPICAL PHYSICAL DEMANDS:** * ... degree in Nursing preferred. * Current Hawaii State license as a Registered Nurse . * Current certification at BLS/HCP level. Additional certifications may be… more
- Humana (Honolulu, HI)
- **Become a part of our caring community and help us put health first** The Utilization Management Behavioral Health Nurse 2 utilizes clinical nursing skills ... documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Behavioral Health Nurse 2 work… more
- Highmark Health (Honolulu, HI)
- …Nursing **EXPERIENCE** **Required** + 7 years in any combination of clinical, case/ utilization management and/or disease/condition management experience, or ... in addressing targeted populations **LICENSES or CERTIFICATIONS** **Required** + RN license in PA or WV or DE or...first 6 months of employment. **Preferred** + Certification in utilization management or a related field +… more
- Queen's Health System (Honolulu, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... physical safety. IV. MINIMUM QUALIFICATIONS A. Education/Certification and Licensure: 1.Licensure: Registered Nurse , State of Hawaii 2.Diploma or Associate… more
- Queen's Health System (Honolulu, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... physical safety. IV. MINIMUM QUALIFICATIONS A. Education/Certification and Licensure: 1.Licensure: Registered Nurse , State of Hawaii 2.Diploma or Associate… more
- Queen's Health System (Honolulu, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... physical safety. IV. MINIMUM QUALIFICATIONS A. Education/Certification and Licensure: 1.Licensure: Registered Nurse , State of Hawaii 2.Diploma or Associate… more
- Queen's Health System (Honolulu, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... physical safety. IV. MINIMUM QUALIFICATIONS A. Education/Certification and Licensure: 1.Licensure: Registered Nurse , State of Hawaii 2.Diploma or Associate… more
- Queen's Health System (Ewa Beach, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... physical safety. IV. MINIMUM QUALIFICATIONS A. Education/Certification and Licensure: 1.Licensure: Registered Nurse , State of Hawaii 2.Diploma or Associate… more
- Queen's Health System (Honolulu, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... physical safety. IV. MINIMUM QUALIFICATIONS A. Education/Certification and Licensure: 1.Licensure: Registered Nurse , State of Hawaii 2.Diploma or Associate… more
- Queen's Health System (Honolulu, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... physical safety. IV. MINIMUM QUALIFICATIONS A. Education/Certification and Licensure: 1.Licensure: Registered Nurse , State of Hawaii 2.Diploma or Associate… more
- Queen's Health System (Honolulu, HI)
- …to, initiation and development of the plan of care, patient/family education, utilization management and discharge planning. II. TYPICAL PHYSICAL DEMANDS ... physical safety. IV. MINIMUM QUALIFICATIONS A. Education/Certification and Licensure: 1.Licensure: Registered Nurse , State of Hawaii 2.Diploma or Associate… more
- Highmark Health (Honolulu, HI)
- …and education or if necessary involve Special Investigation Unit or the Utilization Management area. **ESSENTIAL RESPONSIBILITIES** + Implement the pre-payment ... data to assure appropriate level of payment and resource utilization . It is also used to identify issues which...experience in Managed Care **LICENSES or CERTIFICATIONS** **Required** + Registered Nurse **Preferred** + Certified Medical Coder… more