Data Governance Analyst
Honolulu,
Hawaii
HMSA
Data Governance Expertise and Processes The Data Governance Analyst will coordinate and contribute to the management of governance processes, including reviewing existing processes and assisting in the implementation of new ones aligned wit...
2d
Senior Business Analyst, Command Center
Honolulu,
Hawaii
HMSA
Research and Data analysis Provide quality, objective, and professional analysis of relevant topics Gather and analyze information to identify trends, issues, innovations, and potential problems and solutions related to internal operations ...
2d
Nurse Reviewer - Clinical Review Unit
Kapolei,
Hawaii
HMSA
Utilize medical necessity criteria from established medical policies and clinical practice guidelines to render precertification determinations as described in the Medical Management UM work plan. This detailed clinical judgment includes ev...
4d
Supervisor, Membership Servicing
Honolulu,
Hawaii
HMSA
Monitor the performance and address issues with any business partners or vendors that supports the Members Servicing Department. Build relationships with both internal and external customers to include members and employer groups to address...
5d
Manager, Provider Research
Honolulu,
Hawaii
HMSA
Manage staff, ensuring provider inquiries are responded to timely, accurately, and professionally. Resolve complex provider inquiries. Respond to and oversee staff responding to CMS demand letters. Participate in ad hoc projects to help enh...
5d
Encounters System Analyst I
Honolulu,
Hawaii
HMSA
Analyzes encounter system processes within HMSA and external partners. Coordinates and reconciles exchange of data with external entities. Researches various claim-member-provider scenarios to determine root cause of data submission errors....
6d
Encounters System Analyst II
Honolulu,
Hawaii
HMSA
Sustains strong knowledge of encounter system processes within HMSA and external partners. Coordinates and reconciles data exchange with external entities, monitoring quality. Researches complex claim-member-provider scenarios to determine ...
6d
Senior Encounters System Analyst
Honolulu,
Hawaii
HMSA
Sustains mastery of encounter system processes within HMSA and external partners, for multiple lines of business. Monitors trends in data exchange with external entities and recommends adjustments as needed. Researches highly nuanced claim-...
6d
Accounting Analyst II
Honolulu,
Hawaii
HMSA
Coordinates various projects as assigned. Develops system requirements, test plan, test scenarios, test cases, anticipated test results and objectives and acceptance criteria. Also, performs testing, communicates status/concerns to appropri...
11d
Manager, Configuration
Honolulu,
Hawaii
HMSA
Provide strategic management and direction for the configuration of health plan products, provider networks, and reimbursement methodologies to ensure alignment with business requirements, state and federal regulations, and accreditation st...
13d