New
Performance Reporting Analyst, Command Center
Honolulu,
Hawaii
HMSA
Data Analysis and Reporting Conduct high quality, objective analysis to support performance optimization and strategic initiatives. Collect, interpret, and evaluate Key Performance Indicators (KPIs) and related information to identify trend...
5h
New
Director, Payment Integrity
Honolulu,
Hawaii
HMSA
Strategic Leadership: Develop and execute the organization's payment integrity strategy, aligning with enterprise cost containment goals. Oversee the design and implementation of pre-pay and post-pay review processes. Operational Oversight:...
5h
New
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...
5h
Human Resources Business Partner
Honolulu,
Hawaii
HMSA
Conducts implementation and monitoring activities for a variety of HR programs; typically supports multiple teams/ department within a function. Identifies opportunities to enhance the employee experience and partners with management to dev...
2d
Medical Management Review Analyst I
Honolulu,
Hawaii
HMSA
Analyzes, researches, and interprets medical and claims data while processing authorization requests. This includes: Authorizes requests that clearly meet specified criteria according to department guidelines. Refers requests to Medical Dir...
5d
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...
9d
Senior Accounts Payable Clerk
Honolulu,
Hawaii
HMSA
Prioritizes approved invoices and check requests according to payment terms. Assist with month-end accruals as needed. Familiarizes with company policies and navigating steps in Dynamics GP, Certify and CentreSuite. Verifies approver's leve...
11d
Accounts Receivable Representative
Pearl City,
Hawaii
HMSA
Independently process group and direct payments received from walk-in members and groups while providing all customers with an exceptional customer-focused and positive HMSA Center experience. Ensure that the experience meets the customer's...
11d
Case Resolution Specialist I
Honolulu,
Hawaii
HMSA
Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements. Secures information from int...
11d
Technical Program Manager
Honolulu,
Hawaii
HMSA
Responsible for managing all aspects of the planning, execution, controlling, and closure of projects/programs. Responsibilities include, but are not limited to, the following: Receives high-level business requirements and develops detailed...
11d