Job Details

DIRECTOR OF MEMBER HEALTHCARE

  2021-08-20     Confidential     Honolulu  
Description:

DIRECTOR OF MEMBER HEALTHCARE

Hawaii based construction industry health fund, providing self-funded healthcare benefits to approximately 4,000 active and retired employees plus dependents, seeks a qualified registered nurse (RN) to assist the fund and its members in evaluating and obtaining appropriate, effective, quality medical care.  The candidate will assist members in efficiently accessing quality medical care through effective utilization of network contracted providers including facilities, physicians and ancillary services. This candidate will be responsible for the screening, identification and management of actual and potential large claim cases to produce quality outcomes by means of direct member interactions as well as planning and implementation of disease specific initiatives to increase wellness of member population both at the individual and aggregate level.  Some travel in Oahu and inter-island travel is required (pending state and local travel limitations).

Qualifications include:

  • Bachelor of science in nursing.
  • Current unrestricted registered nurse license in the State of Hawaii.
  • Valid driver’s license and use of personal vehicle for travel is required.  A monthly travel allowance will be provided for local travel.
  • Successful screening of criminal background check conducted by the fund.
  • Recent, direct patient care/clinical experience as a registered nurse or nurse practitioner in Hawaii.
  • Recent Hawaii hospital based or managed care case management, utilization management and/or discharge planning experience (certification desirable).
  • Knowledge of or experience with disease management programs and wellness programs.
  • Experience and ability to work both independently and collaboratively with minimal supervision.
  • Knowledge of health care systems including provider reimbursement methods, group insurance operations, benefit design and cost containment strategies and programs.
  • Familiarity with labor organizations’ structure, goals and objectives.
  • Proficient in public speaking and in making presentations and conducting healthcare workshops.
  • The successful candidate must be a caring individual, able to connect with members on a personal level, be a self-starter, have effective written and verbal communication skills, strong critical thinking skills, and good organizational, decision-making, and analytical skills.

Excellent Salary & Fringe Benefits Including Health Insurance & Pension

Please specify salary requirements and if negotiable. 


Do not contact this company in solicitation of any product or service.

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