ZipRecruiter

Log In

2

Remote Rn Case Review Jobs in Hawaii (NOW HIRING)

TEEMA Group

RN Case Management - REMOTE

Honolulu, HI · Remote

$86K - $98K/yr

Process and review authorization and referral requests, ensuring compliance with policies and high ... Registered Nurse * A minimum of two years of full-time direct clinical care experience. * Ability ...

Apex Informatics

HIM Hospital Coder

Wailuku, HI · On-site +1

Remote/Relocation position PFB job details for HIM Hospital Coder. They are looking for a coder ... Reviews DRG discrepancies from the fiscal intermediary to ensure the appropriate per case DRG ...

next page

Showing results 1-20

All JobsRn Case Review JobsRemote Rn Case Review JobsRemote Rn Case Review Jobs in Hawaii

Remote Rn Case Review information

What is the difference between Remote Rn Case Review vs Remote Rn Utilization Review?

AspectRemote Rn Case ReviewRemote Rn Utilization Review
CredentialsRegistered Nurse (RN), licensure, case review certificationsRegistered Nurse (RN), licensure, utilization review certifications
Work EnvironmentRemote, healthcare settings, insurance companiesRemote, healthcare settings, insurance companies
Employer & IndustryHospitals, insurance firms, healthcare providersInsurance companies, healthcare management organizations

Remote Rn Case Review and Remote Rn Utilization Review roles both involve remote nursing work within the healthcare and insurance industries. While they share similar credentials and work environments, case review focuses on evaluating individual patient cases, whereas utilization review assesses the necessity and appropriateness of healthcare services. Understanding these distinctions helps job seekers identify the right role based on their skills and career goals.

What are popular job titles related to Remote Rn Case Review jobs in Hawaii?

For Remote Rn Case Review jobs in Hawaii, the most frequently searched job titles are:

What job categories do people searching Remote Rn Case Review jobs in Hawaii look for?

The top searched job categories for Remote Rn Case Review jobs in Hawaii are:

What cities in Hawaii are hiring for Remote Rn Case Review jobs?

Cities in Hawaii with the most Remote Rn Case Review job openings:

Remote Rn Case Review jobs near you

RN Case Management - REMOTE

Honolulu, HI • Remote

TEEMA Group
Recruiting and Staffing Services • 51 - 200 employees
Learn more about TEEMA Groupexternal

$86K - $98K/yr

Full-time

Posted 14 days ago

Job description

About Our Client:

Our client is a trusted leader in healthcare services, dedicated to improving outcomes for patients and providers through innovative solutions and high-quality care. Join a team committed to making a meaningful difference in the lives of those they serve.

Role Summary

Our client is seeking a dedicated Case Manager to provide exceptional case management services to beneficiaries, focusing on high-quality care and positive outcomes. This role involves screening, assessing, and developing individualized care plans while ensuring compliance with policies and state-specific licensure requirements. The Case Manager will advocate for beneficiaries, manage referrals and authorizations, and collaborate with healthcare providers to meet the needs of those served.

Key Responsibilities

  • Conduct beneficiary screenings and assessments to determine eligibility for case management services.

  • Develop and implement individualized care plans to address specific needs, goals, and outcomes.

  • Monitor care plans regularly to ensure relevance and effectiveness, making adjustments as needed.

  • Provide advocacy for beneficiaries by ensuring access to care and locating specialized services when necessary.

  • Support beneficiaries with information on resources, including community programs.

  • Process and review authorization and referral requests, ensuring compliance with policies and high-risk factors.

  • Maintain detailed and accurate documentation in the medical management system.

  • Collaborate with providers and internal teams to ensure care plan alignment.

  • Monitor and provide guidance to non-clinical staff to support operational goals.

  • Demonstrate consistent reliability and professionalism in attendance and communication.

Required Qualifications

  • Current, unrestricted state license as one of the following: Registered Nurse

  • A minimum of two years of full-time direct clinical care experience.

  • Ability to obtain a URAC-recognized certification in case management within four years of hire.

  • U.S. citizenship with the ability to obtain a favorable Department of Defense (DOD) background investigation.

Desired Qualifications

  • At least two years of case management experience.

  • Possession of a URAC-recognized case manager certification.

Competencies

  • Technical Skills: Knowledge of case management, HIPAA, URAC standards, policies, and medical coding.

  • Problem-Solving: Effective analytical skills to address complex care scenarios.

  • Communication: Excellent verbal and written skills, adaptable to diverse situations.

  • Organizational Skills: Ability to manage priorities in a fast-paced environment while maintaining attention to detail.

  • Team Player: Ability to inspire collaboration and positively influence outcomes.

Contract to Hire

Location: Remote

We have openings available across multiple states, including Arkansas, Arizona, California, Colorado, Hawaii, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Utah, and Wyoming.

Pay is determined based on years of experience and the state of residence.

This is an exciting opportunity to join a team dedicated to improving healthcare delivery while advancing your expertise in case mangment. Apply now to make a positive impact and grow your career!