Specialist, Managed Care - Utilization Mgmt
: Job Details :

Job DescriptionHawai'i Pacific Health is a not-for-profit health care network with over 70 locations statewide including medical centers, clinics, physicians and other caregivers serving Hawai'i and the Pacific Region with high quality, compassionate care. Its four medical centers - Kapi'olani, Pali Momi, Straub and Wilcox - specialize in innovative programs in women's health, pediatric care, cardiovascular services, cancer care, bone and joint services and more. Hawai'i Pacific Health is recognized nationally for its excellence in patient care and the use of electronic health records to improve quality and patient safety.The Analytics & Management department forms part of the HealthAdvantage Support Services, which provides Hawai'i Pacific Health and its affiliates essential population utilization and financial management support, analyses and modeling. The department also performs additional services in collaboration with the managed care services department including referral management, patient steerage, and claims auditing.As the Specialist, you will be responsible for providing comprehensive managed care information related to Hawai'i Pacific Health contracted health plans, services as customer service representative for all internal and external customers, facilitates health care services by verbal, written, or data communication, and is responsible for screening and processing detailed department records. We are looking for someone who has the ability to anticipate tasks and prioritize assignments independently, pay strong attention to detail and is committed to creating a healthier Hawai'i.Location: Hawaii Pacific Health, Honolulu, HIWork Schedule: Day - 8 HoursWork Type: Full Time RegularFTE: 1.000000Bargaining Unit: Non-BargainingStarting Hourly Rate: 22.02Exempt: NoMinimum Qualifications: Associate's Degree with related experience or an equivalent combination of education, training, and/or related work experience. One (1) year of customer service and managed care experience.Preferred Qualifications: Two (2) years in managed care. Five (5) years in customer service. Proficient in Windows Operating Systems, MS Office Applications. Familiarity with basic medical terminology and CPT, ICD-9 and H.C.P.C.S. codes.EOE/AA/Disabled/VetsHawai'i Pacific Health offers a comprehensive and competitive total rewards package that includes pay and benefits. The pay rate, if displayed, is the minimum hourly rate for the position. Rate of pay for selected candidates will be determined by various factors including knowledge, skills, abilities, relevant experience and training, as well as internal peer equity.Position Specialist, Managed Care - Utilization MgmtCategory AdministrativeEmployment Type EmployeeLocation Hawaii Pacific Health, Honolulu, HIReq ID 24878