RN Case Management Reviewer - Military veterans preferred

Job Title: RN Case Management Reviewer

Location: Adult Mental Health Division. 2201 Waimano Home Road, Hale F, Pearl City, HI 96782

Salary Range: $52.95

About the Role

The Hawaii Adult Mental Health Division (AMHD) is seeking a dedicated and detail-oriented Registered Nurse (RN) Case Management Reviewer to join our administrative mental health team. This role plays a key part in ensuring individuals receive the right level of case management services by evaluating referrals, coordinating with community programs, and supporting service delivery across the state.

You’ll work alongside a passionate team of social workers, program specialists, and fellow RNs, and engage directly with clinics and providers to better understand community needs and available resources. If you’re an RN with strong clinical judgment and a heart for mental health advocacy, we’d love to hear from you.

Key Responsibilities

• Referral Management: Receive and triage case management referrals from internal and external sources.
• Utilization Review: Evaluate clinical documentation to determine eligibility and appropriateness of services using evidence-based criteria and regulatory standards.
• Care Coordination: Match individuals to the appropriate intensity of case management services to ensure quality, efficiency, and continuity of care.
• Community Engagement: Reach out to clinics and providers to assess local needs and available resources, supporting informed referral decisions.
• Team Collaboration: Partner with service coordinators, case managers, providers, and interdisciplinary teams to facilitate smooth handoffs and timely service initiation.
• Documentation & Compliance: Maintain accurate records of review outcomes, level-of-care determinations, and referral assignments in accordance with organizational policies and regulations.
• Quality Improvement: Monitor referral patterns, service capacity, and utilization trends to support ongoing improvements in care delivery.

Qualifications

• Active RN license in the State of Hawaii (or eligibility for licensure).
• Experience in case management, utilization review, or mental health services preferred.
• Strong understanding of clinical guidelines, regulatory standards, and evidence-based practices.
• Excellent communication, organizational, and decision-making skills.
• Ability to work collaboratively in a multidisciplinary team environment.
• Familiarity with community mental health programs and resources is a plus.

Why Join Us?

• Be part of a mission-driven team improving mental health outcomes across Hawaii.
• Collaborate with experienced professionals in a supportive and inclusive environment.
• Engage directly with community providers to make a meaningful impact.
• Opportunities for professional development and career growth.