Utilization Management Nurse
Humana
Humana Inc. is seeking a Part C Grievance & Appeals Nurse (Utilization Management Nurse 2) to support case preparation, evidence review, and collaboration with multidisciplinary teams. Remote position in Hawaii requiring RN with compact license, 3+ years of clinical experience, and proficiency in Word/Outlook/Excel. You will use systems like MHK, CGX, MRM, SRO and participate in process improvements. #J-18808-Ljbffr
- ...Utilization Manager Registered Nurse (UMRN) Spectrum Healthcare Resources has a need for a Utilization Manager Registered Nurse (UMRN). These will be completely remote positions, working entirely from the Nurse's home. The Nurse will be reviewing cases, educating patients...SuggestedFull timeContract workWork at officeRemote workWork from homeMonday to Friday
$70k - $85k
...UM Review Nurse AlohaCare is a local, non-profit health plan serving Hawai`i's low... .... We provide comprehensive benefits and managed care services with an emphasis on healthy... ...external parties that result in outstanding utilization management of members and their...SuggestedTemporary workWork at officeLocal area- ...Creates an environment where front line nurses and ancillary staff provide whole person... ...assigned nursing and ancillary personnel utilizing both professional and supervisory... ...Techniques for Effective Aggression Management (TEAM) or TEAM-A: Required Essential...SuggestedWork experience placementShift work
- ...Nurse Reviewer Applies appropriate medical necessity criteria from established medical... ...as described in the Medical Management UM work plan. This detailed clinical judgment... ...creativity in managing each case to fully utilize all available inpatient and community resources...SuggestedWork at office
$80 per hour
...Registered Nurse (RN) — Per Diem (Home Health)Pay: $80 per visitLocation: Oahu, Hawaii (must have reliable transportation — we serve... ...care plans, and patient educationPerform wound care, medication management, and coordination of careCommunicate with physicians and the...SuggestedDaily paidLocal areaFlexible hours- ...The Wellness Nurse at Ivy at Hawaii Kai (Oakmont Management Group) coordinates resident care and medication management under physician supervision. This full-time role requires coverage seven days a week, supporting the Health Services Director and maintaining strong...Full time
$68 - $73 per hour
Make an Impact as a Registered Nurse at BAYADA Home Health Care BAYADA Home Health Care is currently seeking a Registered... ..., and evaluations pertaining to client care management and services provided, utilizing a state-of-the-art touch pad tablet Compensation & Schedule...Weekly payDaily paidWork at officeLocal areaFlexible hours$32 - $33 per hour
...senior living community situated on a beautifully landscaped campus. Managed by Oakmont Management Group, we provide exceptional quality,... ...Pet Insurance Employee Assistance Program The Medication Nurse is responsible for supervising and assisting in the administration...Hourly payFull timeImmediate startRelocationFlexible hoursShift workNight shiftDay shift$35 - $38 per hour
...Rehabilitation Center in Johnstown, PA is currently seeking Registered Nurses (RNs) Available Shifts: Full-time varied shifts / Rotating... ..., state or local laws and ordinances. Guardian Healthcare's management team is dedicated to this policy with respect to recruitment, hiring...Full timeTemporary workReliefLocal areaShift workRotating shift$65k - $83k
...residing on all islands. We provide comprehensive benefits and managed care services with an emphasis on healthy living habits and... ...community services to the members. Promotes effective healthcare utilization, monitors health care resources and assumes a leadership role...Work at officeLocal areaWeekend workAfternoon shift- ...Aloha Nursing Position Come home to Aloha. Providing personalized skilled nursing, intermediate, long term, respite and hospice... ...atmosphere. Summary of Position: Works closely with the nursing management team in accomplishing the mission of Hale Ho Aloha and...Night shiftAfternoon shift
- ...This position is a Hawaii Nurses and Healthcare Professionals Bargaining Unit represented... .../statutes and organizational policies. Utilizes reasonable judgment in carrying out... ...knowledge of and skill in adaptability, change management, decision making, detail oriented,...
$95k - $105k
.... We provide comprehensive benefits and managed care services with an emphasis on healthy... ..., improved emergency department utilization, and improved care coordination for members... ...transitioning from inpatient facilities, nursing facilities, other congregate settings, and...Work at officeLocal area$68 per hour
...BAYADA Home Health Care is seeking a Registered Nurse (RN) Home Health for a nursing job in Honolulu, Hawaii. Job... ...interventions, and evaluations pertaining to client care management and services provided, utilizing a state-of-the-art touch pad tablet Compensation &...Weekly payFull timePart timeWork at officeLocal areaFlexible hoursNight shift$71.1k - $97.8k
...community As a remote Pre-Authorization Nurse, you will report to a Supervisor of Pre-... ...planning, and refer to Tier III care management as needed. Use your skills to make an... ..., etc.) Preferred Qualifications Utilization Review/Quality Management experience...Full timeContract workTemporary workApprenticeshipInterim roleWork at officeRemote workWork from homeHome office- ...RN - Registered Nurse - Per DiemBristol Hospice - Honolulu, HI - Honolulu, HI 96813OverviewSalary... ...es)Provide professional nursing care by utilizing all elements of the nursing... ...the planning processRecord pain/symptom management and changes/outcomes as appropriateCommunicate...Hourly payDaily paidFlexible hoursShift work
- ...PositionWe're looking for a passionate Home Health Registered Nurse to provide nursing care directly to our patients in their... ..., physicians, and members of the interdisciplinary team, utilizing the case management model. Promotes effective and collaborative communication...
$70 - $75 per hour
...Make an Impact as a Registered Nurse at BAYADA Home Health Care Extensive Retention Bonus BAYADA Home Health... ...interventions, and evaluations pertaining to client care management and services provided, utilizing a state-of-the-art touch pad tablet Compensation & Schedule...Weekly payFull timePart timeWork at officeLocal areaFlexible hours- ...Dialysis And Medical Surgical Registered Nurse As a Dialysis and Medical Surgical Registered... ...patient care in a med-surg setting while managing dialysis treatments. You will work closely with a dedicated team, utilizing your expertise to ensure optimal patient outcomes...Weekly pay
- ...Creates an environment where front line nurses and ancillary staff provide whole person... ...assigned nursing and ancillary personnel utilizing both professional and supervisory... ...Techniques for Effective Aggression Management (TEAM) or TEAM-A: Required Essential...Full timeWork experience placementShift work
- ...Registered Nurse- Labor & Delivery -TAMC Tripler Army Medical Center -TAMC, Hawaii - Honolulu, HI 96859 Description Registered... ...and central indwelling catheters to include PICC lines utilizing syringe pumps. Obtain blood samples from heel sticks, peripheral...Contract workFor contractors10 hours per weekShift workNight shiftDay shift
$44.71 - $47.6 per hour
...Position Summary Under the supervision of the Patient Care Manager, the After Hours Nurse provides clinical nursing support during non-core... ...and initiates intervention to meet the immediate needs by utilizing principles of palliative care and following (but not limited...Hourly payPart timeImmediate startFlexible hoursShift workWeekend work- ...life with our team of specially trained nurses, therapists and reliable caregivers. As... ...outcomes. ESSESNTIAL FUNCTIONS: Case management & follow-up skilled nursing visits in... ...patients. Appropriately identifies and utilizes resources and referrals such as PT, OT,...Part time
$80 - $160 per hour
...Registered Nurse (RN) – Home Health Visits | $80–$160 Per Visit | East Honolulu Earn $80–$160 Per Visit | Flexible Per Diem Schedule | Manage Your Own Caseload Location: East Honolulu, Oahu, Hawaii Are you a compassionate Registered Nurse looking for flexibility, autonomy...Hourly payDaily paidTemporary workWork at officeLocal areaFlexible hours- ...Licensed Practical Nurse For Iramc Services Spectrum Healthcare Resources has a potential opportunity for Licensed Practical Nurses for Integrated Referral Management and Appointing Center (IRAMC) Services in support of the Defense Health Agency and Bremerton Naval...Work at officeRemote workWork from homeMonday to Friday
$45 - $47 per hour
...RN Case Manager Bristol Hospice - Honolulu, HI - Honolulu, HI 96813 Overview Salary Range $45.00 - $47.00 Hourly Position Type FT Hourly Job Shift Day Description Are you a Registered Nurse who thrives on providing compassionate, whole-person care—and wants...Hourly payFlexible hoursShift work- ...attentive Anesthesiology team provides general anesthesia and pain management services for hospital patients and those who have outpatient... ...Services Minimum Qualifications: Graduate of an approved nurse anesthesia program by the Council of Nurse Anesthesia. Current...Daily paid
- Adventist Health is seeking an RN Manager to lead our Birth Center and Labor & Delivery unit in Kailua. In this on-site leadership role... ...care for mothers and newborns. You will supervise and mentor nursing staff, manage budgets and resources, and drive quality and patient...
- ...Home Care specializing in professional health care staffing and management solutions to the Department of Defense, federal government... ...Distinctive Healthcare is currently seeking to hire a full time Family Nurse Practitioner at Hickam AFB. Minimum Qualifications Degree:...Full timeContract workPart timeCurrently hiringShift work
- ...Neonatal Nurse Practitioner NNPOnsite40 hours a week One 24 hour shift (12 working in unit... ...a group of normal-to-high risk infants. Manages neonatal caseload with physician... ...neonatal units during crisis situations. Utilizes planning, implementation, and evaluation...Shift work
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Management Nurse. Be the first to apply!
- internship event management company Honolulu, HI
- entry level emergency management Honolulu, HI
- identity management Honolulu, HI
- director of inventory management Honolulu, HI
- managing broker Honolulu, HI
- management fast track program Honolulu, HI
- nonprofit management Honolulu, HI
- logistics and supply chain management Honolulu, HI
- director program management Honolulu, HI
- change management coordinator Honolulu, HI



