Utilization Manager (LPN) - Daytime UM Specialist

Maytav Bus Co; Honolulu (HI); On-site; USD 48,000 - 68,000; Full time

Job summary

Kahu Malama Nurses in Honolulu, HI, seeks an Utilization Manager (LPN) to support a Hawaii health plan. If you’re a licensed nurse, this weekday role allows you to apply clinical knowledge away from bedside care in a utilization management setting.

Position is full-time; contract. Monday–Friday, 8:00am–5:00pm. Fixed pay rate of $42/hour. Requires active Hawaii LPN/RN license and UM experience or direct patient care background.

Qualifications

• Active Hawaii RN or LPN license.
• At least 1 year of utilization management experience, OR 2 years of hospital direct patient care.
• Experience with UM software, CPT and ICD-10.
• Proficient in Word, Excel, Outlook, and PowerPoint.

Responsibilities

• Review cases using MCG Criteria, CPT and ICD-10 coding, and health plan policies.
• Document and track reviews in UM software.
• 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.

Skills

MS Word

MS Excel

MS Outlook

MS PowerPoint

Strong communication

Time management

Independent work

Education

Hawaii LPN or RN license

Tools

UM software

CPT/ICD-10 manuals

Job description

Kahu Malama Nurses in Honolulu, HI, seeks an Utilization Manager (LPN) to support a Hawaii health plan. If you’re a licensed nurse, this weekday role allows you to apply clinical knowledge away from bedside care in a utilization management setting.

Position is full-time; contract. Monday–Friday, 8:00am–5:00pm. Fixed pay rate of $42/hour. Requires active Hawaii LPN/RN license and UM experience or direct patient care background.