Registered Nurse Case Management Reviewer

Acro Service Corp; Honolulu (HI); On-site; USD 61,992 - 71,635; Full time

Job summary

A healthcare service provider in Honolulu seeks a Registered Nurse Case Management Reviewer. This role involves triaging referrals, conducting utilization reviews, and collaborating with various teams. Candidates should have a valid Hawaii RN license and a bachelor's degree, with 2-3 years of relevant experience preferred. The role offers competitive pay and flexible scheduling options.

Qualifications

• Current, unrestricted Hawaii license as a Registered Nurse (RN).
• Graduation from an accredited four-year college or university.
• Minimum 2-3 years of experience in case management or related field.

Responsibilities

• Receive and triage case management referrals.
• Conduct utilization reviews of clinical information.
• Collaborate with service coordinators and case managers.

Skills

Assessment skills

Critical thinking

Decision-making

Communication skills

Interpersonal skills

Prioritization

Education

Bachelor's degree from an accredited institution

Current Hawaii RN license

Tools

Microsoft Office Suite

Electronic health records software

Utilization management software

Basic PDF Software

E-Signature Tools

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 bachelor\u2019s 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.