- Evolent (Honolulu, HI)
- …Evolent for the mission. Stay for the culture. **What You'll Be Doing:** The Clinical Review Nurse is responsible for performing precertification and prior ... policies, and clinical decision-making criteria sets. The Clinical Review Nurse serves as... medical necessity and appropriateness of services using clinical review criteria. + Accurately documents all… more
- CenterWell (Honolulu, HI)
- …complaints. + Makes clinical level of care determination based on discussion, medical records, and any other pertinent clinical data. Matches these needs to ... to work every other holiday.** The **Care Manager, Telephonic Nurse ** helps to ensure optimal continuity of care for...Health, Hospice, and Palliative Care Services. + Assist with clinical eligibility review for alternate services +… more
- Datavant (Honolulu, HI)
- …years of CDI experience + 3+ years of clinical experience in an academic medical center + Registered Nurse license, Bachelor's degree in Nursing + CCDS or ... realize our bold vision for healthcare. **What We're Looking For:** As a Clinical Documentation Quality Improvement (CDQI) Specialist, you will play a pivotal role… more
- BAYADA Home Health Care (Honolulu, HI)
- **BAYADA Home Health Care** is currently seeking a **full-time Clinical Manager (RN required)** in our Medicare certified **Oahu Visits office in Honolulu, Hawaii** ... . As one of the Clinical Managers, you will lead the field staff in...hire onboarding and orientation of field staff + Documentation review , including OASIS and Home Care Home Base (HCHB)… more
- Highmark Health (Honolulu, HI)
- …:** Allegheny Health Network **Job Description :** **GENERAL OVERVIEW:** This job performs clinical review and data abstraction of patient records to support ... Preferred + Associate's or Bachelor's Degree in Nursing + 1 year performing medical record review and data abstraction for cardiovascular registries + Proficient… more
- CenterWell (Honolulu, HI)
- …will collaborate with other health care givers in reviewing actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review ... Compact Nursing License + A minimum of three years clinical RN experience; + Prior clinical experience,...extends outside of work. Among our benefits, Humana provides medical , dental and vision benefits, 401(k) retirement savings plan,… more
- Oracle (Honolulu, HI)
- …+ Excellent communication, stakeholder engagement, and leadership skills. **Preferred Qualifications:** + Clinical experience as a nurse or physician with a deep ... **Job Description** The Clinical Note AI Agent Product Management Leader will...Gather and analyze information to define product specifications and review design specifications. Envision and communicate product strategy and… more
- Queen's Health System (Honolulu, HI)
- …* Responsible for assisting in the overall quality and completeness of clinical documentation throughout The Queen's Health Systems, through concurrent medical ... reviews and query process. * Responsible for the concurrent review of provider documentation to ensure the appropriate capture...of patient care teams to ensure the integrity of medical record documentation and allow for accurate and complete… more
- Queen's Health System (Honolulu, HI)
- …activities in accordance with department's goals and objectives and mission of The Queen's Medical Center (QMC) and The Queen's Health Systems (QHS). * Serves as a ... resource for medical staff and medical center departments in...credentialing agencies, etc. * Coordinates, implements and facilitates key clinical performance improvement efforts including, but not limited to:… more
- Queen's Health System (Honolulu, HI)
- …process for oncology patients. * Serves as an advocate, interpreter, educator and clinical resource with expertise in medical , surgical, and radiation oncology ... RESPONSIBILITIES Review Date: 07/23 Effective Date: 08/20 I. JOB...LICENSURE: * Current Hawaii State License as a Registered Nurse . * Bachelor's degree in Nursing. * Certification in… more