Utilization Manager (LPN) - Daytime, Non-Bedside UM Lead

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

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.