24 Results for

Medical Case Management Jobs in Honolulu, HI

Jobs

Aiea, HI30+ days ago

$127,691–$159,619 Per Year

The hospital has delivered many medical firsts for the community, including Central and West Oahu's only interventional cardiac catheterization unit to detect and treat heart disease, a fully integrated minimally invasive surgical suite, a comprehensive women's center, CT scan and MRI services, and the state's first retina center. As the Registered Nurse Case Manager, you would ensure the considerate and confidential management of unique and high-risk patient cases by performing case management through direct referrals and reviews of medical records.

Honolulu, HI15 days ago

$52,680–$68,485 Per Year

FOREIGN EDUCATION: If you are using education completed in foreign colleges or universities to meet the qualification requirements, you must show the education credentials have been evaluated by a private organization that specializes in interpretation of foreign education programs and such education has been deemed equivalent to that gained in an accredited U.S. education program; or full credit has been given for the courses at a U.S. accredited college or university. Time-in-grade documentation: If you are applying for a higher grade and your SF-50 has an effective date within the past year, it may not clearly demonstrate you meet the one year time-in-grade requirement so you will need to provide an SF-50 which clearly demonstrates you meet the time-in-grade requirements (examples of appropriate SF-50s include Promotions, Within-grade Grade/Range Increases, and SF-50s with an effective date more than one year old).

Aiea, HI30+ days ago

$95,000–$100,000 Per Year

Registered Nurse (RN), Nursing, Home Care Registered Nurse, Emergency Room Registered Nurse, Clinical Nurse, Nurse Case Manager, Field Case Manager, Medical Nurse Case Manager, Workers Compensation Nurse Case Manager, Critical Care Registered Nurse, Advanced Practice Registered Nurse (APRN), Nurse Practitioner, Case Management, Case Manager, Home Healthcare, Clinical Case Management, Hospital Case Management, Occupational Health, Patient Care, Utilization Management, Acute Care, Orthopedics, Rehabilitation, Rehab, CCM, Certified Case Manager, CDMS, Certified Disability Management Specialist, CRC, Certified Rehab Certificate, CRRN, Certified Rehab Registered Nurse, COHN, Certified Occupational Health Nurse, CMC, Cardiac Medicine Certification, CMAC, Case Management Administrator Certification, ACM, Accredited Case Manager, MSW, Masters in Social Work, URAC, Vocational Case Manager. As a Field Case Manager, you will work closely with treating physicians/providers, employers, customers, legal representatives, and the injured/disabled person to create and implement a treatment plan that returns the injured/disabled person back to work appropriately, ensure appropriate and cost-effective healthcare services, achievement of maximum medical recovery and return to an optimal level of work and functioning.

"-", HI13 days ago

Remote

$86,000–$98,000

Our client is seeking a dedicated Case Manager to provide exceptional case management services to beneficiaries, focusing on high-quality care and positive outcomes. Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care.

Kapolei, HI30+ days ago

Process vendor authorization files to reflect the appropriate decisions within HMSAs system to appropriately and accurately impact claims processing to include but not limited to the following: Researching, validate, and update existing authorizations based on extensions, peer to peer reviews, and updates requested from provider community. Evaluation interpretation and processing of clinical review requests to include but not limited to applying the following requirements: Validation that requests has met submission requirements based on accreditation, governmental regulation requirements.

HONOLULU, HI30+ days ago

$93,000–$99,000 Per Year

Under the supervision of the Patient Care Manager, the Nurse Case Manager serves our patients by utilizing principles of palliative care and holistic philosophy to provide care that reflects skilled nursing judgment, medical necessity, measurable patient caregiver, and reasonable goals. Ability to set priorities, research, problem-solve, and make independent decisions with minimal supervision by using logic to identify key facts, explore alternatives, and propose quality solutions within the scope of the job.

Honolulu, HI12 days ago

Drives services related to the initial case assessment by: interviewing patients and their families to evaluate needs, goals, and current services with minimal day-to-day supervision; determining initial eligibility, benefits, and education for all admissions independently; reviewing and entering authorization data (e.g., authorization data regarding admitting/principle diagnoses, bed type(s), and disposition data for accuracy, after visit summary) and identifying and documenting inaccuracies; recommending research plans that identify new and/or existing options to assure that quality, cost-efficient care is provided; and leveraging comprehensive knowledge to assess medical necessity for hospital admission and required level of care to inform physician. Provides services related to patient disposition by: identifying patients ready for disposition planning activities under limited guidance; developing, evaluating, coordinating, and communicating a comprehensive disposition plan in collaboration with the patient, family, physician, nurses, social services, and other healthcare providers and agencies to meet each patients personal, psychosocial, economic, and cultural needs with guidance; and obtaining authorizations/approvals as needed for services for the patient with minimal supervision.

Waipahu, HI17 days ago

Provides continuity of care to patients by coordinating care and services needed by patients and members who are at high risk of readmission to the emergency room and/or hospital. Provides case management services to patients/families requiring complex care management by assessing and evaluating their needs and any potential care gaps.

Honolulu, HI30+ days ago

The Case Manager shall collect, organize, record, and communicate data relevant to primary health assessments including a detailed medical history in order to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations. The Nurse Case Manager, hereafter referred to as the Case Manager, shall provide a full range of professional health nursing principles, practices, and procedures in clinical settings in order to analyze the full scope of problems associated with providing appropriate, cost effective care to Department of Defense (DOD) beneficiaries.

Honolulu, HI16 days ago

Identifies and maintains relationships with translation resources in the community, including private services, volunteers, universities, English as a Second Language (ESL) schools, NGOs, churches, and other organizations that might have resources to offer. At least two (2) years of customer service or case management experience required; experience in fields related to law, social work, detention, corrections or working with multi-cultural clients preferred.

Kaneohe, HI30+ days ago

$18–$20

You will be developing clinically based treatment relationships with persons diagnosed with serious and persistent mental illness and helping them integrate into the community using a structured recovery plan: obtaining psychiatrist visits, medications, housing, substance abuse treatment, legal coordination and other services. Required 6-12 months supervised experience (work, volunteer, or a combination) with at least one of the following populations: severely mentally ill (SMI/SPMI), developmentally disabled (DD), elderly, children, or other special needs populations.

Kaneohe, HI30+ days ago

$42,000–$56,000

You will be developing clinically based treatment relationships with persons diagnosed with serious and persistent mental illness and helping them integrate into the community using a structured recovery plan: obtaining psychiatrist visits, medications, housing, substance abuse treatment, legal coordination and other services. Preferred 6-12 months supervised experience (work, volunteer, or a combination) with at least one of the following populations: severely mentally ill (SMI/SPMI), developmentally disabled (DD), elderly, children, or other special needs populations.

Honolulu, HI30+ days ago

Negotiates fees on behalf of members for non-covered or nonparticipating provider services in addition to soliciting claims and other related medical information from providers in order to resolve member inquiries. Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements.

Honolulu, HI30+ days ago

Assists Supervisor and Coordinator in working as a liaison with providers, members and internal decision makers in representing HMSA objectives, goals, and expectations for meeting contractual, regulatory, and accreditation requirements. Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements.

Honolulu, HI18 days ago

Are you a Registered Nurse who thrives on providing compassionate, whole-person care-and wants to be more than just a caregiver, but a true advocate, companion, and comfort to patients and their families?. Bristol Hospice is a nationwide industry leader committed to providing a family-centered approach in the delivery of hospice services throughout our communities.

Honolulu, Hawaii30+ days ago

The Director of Risk Management & Safety is responsible for the strategic oversight and day-to-day administration of the company’s risk management, insurance, workplace safety, and workers’ compensation programs for a diverse workforce of approximately 5,000 employees of the company and affiliated entities supported by the company. This role ensures compliance with Hawaii-specific regulatory requirements, minimizes financial and operational risk, reduces workplace injuries, and supports a safe work environment across retail stores, distribution, offices, and support operations.

Honolulu, HI30+ days ago

Remote

Part-time

Collaborates with VA, military treatment facility and network providers and TriWest staff to assure timely, appropriate and high quality care. Independent Thinking / Self-Initiative: Thinks critically with ability to focus on things which matter most to achieving outcomes.

Honolulu, HI27 days ago

As a leader of the Patient Centered Medical Home Team, this position will provide healthcare to adult and pediatric patients by leading a care management team using the patient-centered medical home team model. The person in this position is a member of the Patient Centered Health Care Home team where each team member plays an integral role in providing patient-centered health care.

Honolulu, HI27 days ago

As a leader of the Patient Centered Medical Home Team, this position will provide healthcare to adult patients by leading a care management team using the patient-centered medical home team model. The person in this position is a member of the Patient Centered Health Care Home team where each team member plays an integral role in providing patient-centered health care.

HI30+ days ago

$143,300–$177,980 Per Year

Responsibilities • Responsible for driving sales and achieving sales goals across Specialty portfolio within assigned geography • Identify, qualify, prepare, and execute effective sales strategies that maintain the existing base of business and support the close of competitive and revenue growth opportunities • Lead territory opportunity development and activities that translate to accurate monthly, quarterly, and annual projections • Effectively utilize and update sales tools to accurately address trends in existing base of business, create call strategies, and to manage territory and strategic business plans • Develop mastery of all products and sales applications • Coordinate and collaborate with field sales, marketing & sales operations teams to drive incremental revenue and achieve target sales goals • Present proposals, negotiate pricing and effectively differentiate Cardinal Health • Complete conversions and in-servicing, which includes demonstrating product applications, functionality and use - (occasional night shifts) • Build consultative relationships with key customers and maintain positive working relationships with external business partners • Complete all administrative requirements in a timely and comprehensive manner (expenses, compliance, CRM, as directed) • Educate buyers and promote Cardinal's products through participation in sales meetings, training programs, conventions, and trade shows as directed • Meet and maintain the requirements of all key vendor credentialing entities • Maintain knowledge of the current industry / competitive landscape including, GPOs, healthcare economics, reimbursement, competitors and competitive products etc. Qualifications • Bachelor's Degree or relevant experience preferred • Minimum of 5 - 7 years of documented outside sales success in a competitive, sophisticated environment (complex capital or tangible products including medical/surgical, copiers, payroll solutions, information) preferred • Medical Device industry experience preferred • Excellent phone, written, and in-person communication skills • Key account development with experience accessing and developing key hospital decision-makers and influencers preferred • A valid drivers license issued in one of the 50 States with a clean driving record • Ability to travel domestically and within region often involving overnight stays and stays up to one week in duration • Ability to understand complex contracting and develop sound financial business case preferred • Customer/Vendor credentialing is required (this may include vaccinations).

Honolulu, HI15 days ago

$124,308–$315,000 Per Year

If you are on active duty and expect to be discharged or released from active duty service within 120 days, you may submit a Certificate of Release or Discharge from Active Duty from the appropriate Branch Personnel Office containing the following information: (1) the military service dates including the expected discharge or release date; (2) and the character of service (must be an honorable or general discharge); and (3) any qualifying service/campaign/expeditionary medals. Evidence of equivalency to accredited schools in the United States is demonstrated by permanent certification by the Educational Commission for Foreign Medical Graduates, a fifth pathway certificate for Americans who completed pre-medical education in the United States and graduate education in a foreign country, or successful completion of the U.S. Medical Licensing Examination.

Honolulu, HI11 days ago

At Bristol Hospice, we're looking for compassionate and courageous Registered Nurses to serve as our Warriors of the Night - the calm in the storm and the trusted presence for patients and families during critical after-hours moments. We are dedicated to our mission that all patients and families entrusted to our care will be treated with the highest level of compassion, respect, and dignity.

Honolulu, HI30+ days ago

$23.53–$24.77 Per Hour

With over 200 physicians who are leaders in their fields Straub provides its patients with diagnoses and treatments for more than 32 different medical specialties including bone and joint heart cancer endocrinology diabetes family medicine gastroenterology geriatric medicine internal medicine vascular and urology. Founded in 1921 Straub Benioff Medical Center includes a 159-bed hospital in Honolulu a network of neighborhood clinics and a visiting specialist program that reaches throughout the state of Hawaii.

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Medical Case Management Jobs in Honolulu, HI

Case Manager, RN - Case Management Hawaii Pacific Health

Case Management Care Coordinator (Office Automation) U.S. Department of Defense

Medical Field Case Manager Enlyte Group LLC

RN Case Management - REMOTE TEEMA Group

Medical Management Specialist I Hawaii Medical Service Association

Nurse Case Manager (RN | Full Time) Navian Hawaii

Nurse Case Manager, Palliative & Oncology Care Kaiser Permanente

Case Manager RN Complex Care Kaiser Permanente

Nurse Case Manager Loyal Source Government Services LLC

Case Manager Immigration Bilingual Spanish The GEO Group Inc

Overnight Residential Case Manager (Crisis Stabilization Facility) Community Empowerment Resources (CER)

Evening Shift Residential Case Manager - Crisis Stabilization Facility Community Empowerment Resources (CER)

Case Resolution Specialist II Hawaii Medical Service Association

Case Resolution Specialist I Hawaii Medical Service Association

RN Case Manager Bristol Hospice, LLC

Director of Risk Management and Safety Foodland Super Market

Medical Director TriWest Healthcare Alliance

Medical Doctor - Family Medicine Kalihi Palama Health Center

Medical Doctor - Internal Medicine Kalihi Palama Health Center

Sales Representative - Specialty Medical Products Cardinal Health Inc

Physician (Medical Officer) - Direct Hire U.S. Department of Justice

On Call Nurse Bristol Hospice, LLC

RN On Call - 7 On/7 Off Bristol Hospice, LLC

Nurse Aide - Neuro Progressive Care Unit Hawaii Pacific Health

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