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Nurse Reviewer, Inpatient Utilization & Medical Necessity

Job in Honolulu, Honolulu County, Hawaii, 96814, USA
Listing for: Hawaii Medical Service Association
Full Time position
Listed on 2026-08-29
Job specializations:
  • Healthcare
    Healthcare Nursing, Healthcare Administration
Salary/Wage Range or Industry Benchmark: 59000 - 116000 USD Yearly USD 59000.00 116000.00 YEAR
Job Description & How to Apply Below

Hawaii Medical Service Association is seeking a Concurrent Nurse Reviewer for the Facility Utilization Review Unit. The role requires applying clinical and policy criteria to determine the appropriateness of inpatient stays and suspended claims for HMSA members.

Under minimal supervision, you will coordinate with medical directors, case management, and other teams, ensuring accurate documentation and adherence to accrediting and regulatory guidelines. Hawaii licensure is required.

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