Quality Assurance Trainer
Honolulu,
Hawaii
HMSA
Conducts pre-payment, post-payment, and procedural audits. Assesses training needs based on audit results. Conducts group or one-on-one training. Performs post-training audits to ensure training effectiveness. Makes recommendations regardin...
16d
Utilization Management Business Coordinator
Honolulu,
Hawaii
HMSA
Utilize project management techniques to lead projects and business analysts to coordinate focused medical review projects as assigned. Document and present relative data and recommendations to management and/or oversight committees. Collab...
16d
Manager, Actuarial Pricing
Honolulu,
Hawaii
HMSA
Recommends competitive and sustainable pricing for products based on actuarial models and market trends Leads product updates, maintains competitiveness and addresses customer needs throughout the product lifecycle Develops and implements d...
19d
Account Servicing Advocate I
Keaau,
Hawaii
HMSA
Resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by: Researching and collaborating with other unit...
19d
Senior Analyst, Strategic Contract Management
Honolulu,
Hawaii
HMSA
Vendor Management and Oversight Analyzing Contract Terms: Identifying risk/opportunities within contract terms; conducting risk assessments. Drafting and Reviewing Contracts: Ensuring accuracy of contracts, compliant with relevant laws/regu...
20d
Public Relations and Social Media Specialist
Honolulu,
Hawaii
HMSA
Manage HMSA's social media profiles and presence. Create, manage, and grow HMSA's business presence across relevant social media channels, including, but not limited to Facebook, Instagram, X (formerly Twitter), LinkedIn, Yelp, and YouTube....
21d
Business Analyst, Medicare Stars
Honolulu,
Hawaii
HMSA
Quality Improvement Interventions Analysis and Development: Work as part of the Stars team to continuously identify, plan, develop, implement, and evaluate interventions. Develop reports, analyses, and data mining to support program plannin...
22d
Behavioral Health Navigator
Honolulu,
Hawaii
HMSA
Assessment Provide telephonic screening of BH members using PHQ-9, GAD, and other CM-DM diagnostic tools to determine additional care support needs. Communication Communicates with HMSA members, physicians, case managers, and disease manage...
23d
Network Policy Analyst
Honolulu,
Hawaii
HMSA
Fee Reviews Lead the Fee Review Process which includes analyzing and explaining complex policy and reimbursement issues to providers, Professional Reimbursement and HMSA leadership Prepare cases for Operations Management Committee decision ...
23d
Principal System Engineer
Honolulu,
Hawaii
HMSA
Design Solutions: Serve as a technical leader on our most demanding, cross-functional projects. Balance technical leadership with strong business judgment to make the right decisions about technology choices. Decompose complex problems into...
23d