Registered Nurse Case Management Reviewer Job at Acro, Honolulu, HI

Vnc5YllFLysxVUpNVzAzNEpYR0o2eldiMmc9PQ==
  • Acro
  • Honolulu, HI

Job Description

Overview

Job Title: Registered Nurse (RN) Case Management Reviewer/Service Coordinator

Company: Acro Service Corp

Duration: Through June 30, 2027 (With possible extension)

Hours: 7:45 am - 4:30 pm, Monday through Friday. Flex time may be approved by supervisor.

Base pay range: $45.00/hr - $52.00/hr

Job duties / Responsibilities
  • Receive and triage case management referrals from internal and external sources (providers, hospitals, community agencies, payers, consumers, etc.).
  • Conduct utilization reviews of clinical information to determine eligibility and appropriateness of services.
  • Apply standardized criteria and clinical judgment to match individuals to the correct intensity of case management (e.g., intensive, moderate, or supportive).
  • Collaborate with service coordinators, case managers, providers, and interdisciplinary teams to ensure smooth referral handoffs and timely service initiation.
  • Document review outcomes, level-of-care determinations, and referral assignments in compliance with organizational policies and regulatory requirements.
  • Monitor referral patterns, service capacity, and utilization trends to support continuous quality improvement.
  • Provide consultation and clinical expertise to service coordination staff regarding case complexity, level-of-care needs, and treatment planning.
  • Participate in training, audits, and quality assurance activities related to utilization management and case management processes.
  • Perform other duties as assigned.
Equipment to be used
  • Computer
  • Telephone
  • Fax
  • Copy machine
Minimum knowledge, skills, and education and/or experience
  • Current, unrestricted Hawaii license as a Registered Nurse (RN).
  • Graduation from an accredited four (4) year college or university with a bacheloru2019s degree.
  • Minimum 2-3 years of experience in case management, utilization management, or related clinical setting.
  • Strong knowledge of case management models, medical necessity criteria, and community-based care systems.
  • Excellent assessment, critical thinking, and decision-making skills.
  • Strong communication and interpersonal skills for interdisciplinary collaboration.
  • Ability to manage multiple referrals, prioritize workload, and meet time-sensitive deadlines.
  • Experience with electronic health records and utilization management software preferred.
Minimum computer software skills/knowledge to be used
  • Microsoft Office Suite, especially Word, Excel, Outlook. Drafting and editing contracts, using templates, formatting legal documents. Managing emails, scheduling meetings, and tracking communications.
  • Basic PDF Software. Creating, editing, combining, annotating, and securing PDF documents.
  • E-Signature Tools. Sending documents for signatures, tracking sign-off status, storing signed documents.
Expected length of assignment

Now through June 30, 2027.

EEO Statement

The Company is an Equal Opportunity Employer and is committed to creating an equitable and inclusive environment for all.

#J-18808-Ljbffr

Job Tags

Work at office, Monday to Friday, Flexible hours,

Similar Jobs

USASJB

Work from Home Customer Service Representative Job at USASJB

 ...Work from Home Customer Service Representative We are looking for people who are motivated to participate in paid research across the country and local areas. Join this Work from Home USA Market Research Panel Today. You have two options when it comes to paid research... 

Minnesota Department of Employment and Economic Development

Unemployment Law Judge - Compensation Attorney Job at Minnesota Department of Employment and Economic Development

 ...communities throughout Minnesota. Working Title: Unemployment Law Judge Job Class: Compensation Attorney Agency: Department...  ...The background check may consist of the following components: Criminal Background Check Employment Records Check (current and former... 

Nuvance Health

Physician Assistant Hospitalist - Nights (potential for $10K Hiring Bonus) Job at Nuvance Health

 ...Physician Assistant Hospitalist - Nights (potential for $10K Hiring Bonus) at Nuvance Health summary: The Physician Assistant Hospitalist works night shifts providing primary medical care under physician supervision in a community hospital setting. The role requires... 

ADEX Healthcare Staffing LLC

Travel Post-Anesthesia Care Unit Registered Nurse Job at ADEX Healthcare Staffing LLC

 ...Job Description ADEX Healthcare Staffing LLC is seeking a travel nurse RN PACU - Post Anesthesia Care for a travel nursing job in Saint Louis, Missouri. Job Description & Requirements ~ Specialty: PACU - Post Anesthesia Care ~ Discipline: RN ~ Start Date... 

Sysco

Fleet and Facility Maintenance Director Job at Sysco

 ...repair, and appearance of the facility, fleet shop, outside grounds, office space, beverage...  ...include, but are not limited to, expense management, compliance with government regulations,...  ...regulations/legislation and governing bodies. * Successfully engage and lead individual...