Vacancy expired!
Bishop & Company is seeking candidates for aÂRN Care SpecialistÂopportunity with an health insurance organization in Downtown Honolulu, HI.
RN Care Specialist#17337
Position Summary:
The RN Care Specialist I bridge the gap between administrative needs, data driven imperatives and the clinically relevant needs of our members. Nurses must emphasize these issues (access, quality, safety, statutory medical necessity, and attention to chronic disease) with alacrity and special attention to vulnerable populations while using clinical knowledge and judgment to align resources with member needs. This position effectively coordinates patient care/unit activities among the department, nursing peers, and physicians.
Essential Duties & Responsibilities:
Performs utilization management and care management under the direct supervision of the department clinical leadership
Performs utilization management and care coordination for less complex cases, while acquiring the necessary competencies for handling complex cases
Performs needs assessments, discharge planning and follow-up care coordination for members being discharged from inpatient careÂ
Confers with medical directors as necessary for any quality or safety issues identifiedÂthrough the course of the reviews to discuss actions necessary to further patient safety andÂall elements of the triple aim
Education and Experience:
Nursing Diploma or Associate degree in nursing from an accredited nursing program. Bachelors Degree in Nursing or related field from an accreditedÂcollege or university preferred.ÂNew graduates are encouraged to apply!
Unrestricted, valid, and active RN License for the State of Hawaii.
Practice strong assessment and critical thinking skills and able to multi-task with demands of nursing industry.
Possess excellent interpersonal skills and are able to work cohesively with the entireÂNursing / Administrative team.
Valid drivers license and proof of automobile insurance.
Preferred and Advanced Qualifications:
Prior work experience in a similar role in care and/or utilization management preferred
Familiar with ICD-9/10 and CPT coding desirable
Knowledge of QNXT system desirable
Certification in Utilization Review or Care Management desirable
Other related specialized certification, desirable
Familiar with health insurance benefit management, community resources, and evidence-based medical guidelines
Physical Demands/Working Conditions:
Able to drive an automobile as needed to travel to hospitals on Oahu and, if necessary by airplane to the outer islands
Requires frequent standing, walking, sitting, stooping, walking, seeing, hearing and speaking
Daily use of a computer keyboard, mouse and viewing of a computer monitor
Requires on-site visits at facilities, provider offices, or other settings
Additional Information:
Typically Monday Friday business hours. Extended and weekend hours may be required, depending upon the workload
Direct hire opportunity
Downtown Honolulu, HI
Bishop & Company provides recruiting and placement services for client companies and opportunities for job seekers throughout Hawaii, with emphasis on executive search, direct hire, temp to hire, and temporary/contract staffing. We charge no fees to our placed candidates and our temporary/contract employees. Our client services are 100% guaranteed.
Please forward resumes to:
Bishop & Company
Phone: 808-839-2200
Fax: 808-839-4844
Website:Âhttp://www.bishopco.net/
No relocation, In-state applicants only. Must be available to interview immediately.
Location: Honolulu, HI
Equal Opportunity Employer Disability and Veteran
Vacancy expired!