Utilization Manager (LPN)

Kahu Malama Nurses; Honolulu (HI); On-site; USD 48,000 - 68,000; Full time

Job summary

Kahu Malama Nurses in Honolulu, HI is seeking a Utilization Manager (LPN) for a Monday-Friday daytime schedule. This role focuses on non-bedside utilization management with the opportunity to apply clinical knowledge in a growing managed care environment.

As an LPN with UM experience, you will review cases, document reviews, and communicate with providers and members while leading training sessions and collaborating with internal teams.

Qualifications

• Active LPN or RN license in Hawaii is required.
• 1 year of utilization management experience or 2 years of direct hospital care.
• Experience with UM software and CPT/ICD-10 manuals or ability to learn.
• Intermediate skills in MS Word, Excel, Outlook and PowerPoint.

Responsibilities

• Review cases using MCG Criteria, CPT and ICD-10 coding per policies.
• Document and track reviews using utilization management software.
• Communicate with providers, members, and internal teams by phone and in writing.
• Lead training sessions using audiovisual presentations.
• Manage multiple priorities across teams in a fast-paced setting.

Skills

Active LPN license

UM experience

MS Office

Communication skills

Time management

Independent work

CPT/ICD-10 knowledge

Education

LPN or RN license (Hawaii)

Tools

UM software

MCG Criteria

CPT/ICD-10 manuals

MS Word

Excel

Outlook

PowerPoint

Job description

Position: Utilization Manager (LPN)

Location: Honolulu, HI

Pay: This position has a fixed rate of $42/hour

Type: Full-time; Contract

Schedule: Monday-Friday, 8:00am to 5:00pm

Kahu Malama Nurses is looking for a Utilization Manager (LPN) to support a leading Hawaii health plan. If you're a licensed nurse who wants a weekday schedule away from the bedside, this temporary role lets you put your clinical knowledge to work in utilization management.

What You'll Do

• Review cases using MCG Criteria, CPT and ICD-10 coding, and health plan policies and procedures.
• Use utilization management software to document and track reviews.
• Communicate with providers, members, and internal teams by phone and in writing.
• Lead training sessions using audiovisual presentations.
• Juggle multiple priorities across teams in a fast-paced environment.

What You'll Need

• An active RN or LPN license in the State of Hawaii.
• At least 1 year of utilization management experience, OR at least 2 years of direct patient care in a hospital.
• Experience with, or the ability to learn, UM software, MCG Criteria, and CPT and ICD-10 manuals.
• Intermediate skills in Microsoft Word, Excel, Outlook, and PowerPoint.
• Strong written and verbal communication, including professional phone skills.
• Critical thinking, sound judgment, and strong problem-solving and conflict resolution skills.
• The ability to work independently with little supervision and to stay professional under pressure.
• Strong time management and organization skills, plus dependability and self-motivation.

Why you'll like it

• A Monday-Friday daytime schedule with weekends off.
• Non-bedside clinical work in the managed care field.
• A chance to grow your utilization management experience.

Kahu Malama Nurses is part of Array Corporation, the leading technology-enabled workforce solutions company whose mission is to fix how work is bought, sold and delivered to enable access to the American Dream.

We are proud to be an Equal Employment Opportunity and All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.