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Utilization Reviewer (Call-in)

Job ID KMH-1825953 Date Posted 12/31/2018 Location Ewa Beach, Hawaii
Position Overview:
Located on 14.5 acre campus, Kahi Mohala's 88-bed facility is Hawaii's only private, freestanding psychiatric hospital and center for psychiatry.  Kahi Mohala provides comprehensive behavioral health services for adults, adolescents and children experiencing problems with psychiatric disorders, alcohol and drug abuse, anxiety, depression, eating disorders, emotional disturbances and work of family relationship challenges.
Reviews all patients admitted to Kahi Mohala Hospital programs, assures that they meet admitting criteria and continue stay criteria for each level of care. Performs telephonic concurrent reviews with 3rd party payor as needed.  Attends all managed care meetings as directed.  Assures appropriate documentation to support level of care.  Participates as an active team member; performs other duties as assigned.


Qualifications:
Education/Licensure:
Graduate of accredited RN program, BSN with managed care experience preferred; current Hawaii RN license required. 
Experience:
Seasoned inpatient psychiatric, managed care / utilization review and quality assurance experience required. 
Knowledge:
Familiarity and clear understanding of regulatory/contractual standards (ie. TJC, Tricare, CAMHD). Knowledge of admission criteria and continued stay criteria for each level of care.
Skills:
Effective verbal communication, excellent telephone skills/etiquette. Must be computer literate, able to prioritize, delegate and problem solve. 


Organization: Kahi Mohala Hospital, Hawaii
Employee Status: Regular
Employee Referral Bonus: No
Benefits: No
Position Status: Non-Exempt
Union: No
Job Shift: Day
Shift Hours: 8 Hour Shift
Days of the Week Scheduled: Varied Days
Weekend Requirements: None
Schedule: Per Diem
Hrs Per 2wk Pay Period: varies

All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity, or expression, ancestry, national origin, age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy, childbirth or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.