Senior Manager, Member Advocacy & Appeals
Honolulu,
Hawaii
HMSA
Responsible for managing day-to-day operations of the Member Advocacy and Appeals Department including the investigation and resolution of cases, compliance with required processes, tracking, reporting, notifications to members and provider...
19d
Healthcare Services Analyst II
Honolulu,
Hawaii
HMSA
Research and Analysis: Research and respond to low to medium complexity internal and external inquires. Is proficient at utilizing a variety of resources including but not limited to on-line information files and databases, Medicare/other p...
20d
Medical Management Policy and Research Analyst II
Honolulu,
Hawaii
HMSA
Revise and/or develop medical policies in conjunction with assigned medical director and in accordance with Development and Approval of Medical Policy administrative policy; process includes appropriate and timely implementation and publica...
20d
Technical Financial Analyst
Honolulu,
Hawaii
HMSA
Coordinates with all levels of IT and business management to gather, analyze, summarize, and prepare recommendations regarding budget plans, trend future requirements and operating forecasts. Model business scenarios, funding investment sce...
20d
Account Servicing Advocate I
Honolulu,
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...
21d
Case Manager/Health Coordinator, IHMS
Kapolei,
Hawaii
HMSA
Conduct timely face to face assessments and develop, document, and implement targeted health action plans/care plans based on the results of the assessment for members requiring assistance with care coordination. Coordinate a multi-discipli...
21d
Solution Architect
Honolulu,
Hawaii
HMSA
Responsibilities include, but are not limited to the following: Influence information strategy: By partnering with business unit leadership, and through the rationalization of the information value chain, the information architect will prov...
22d
Healthcare Services Analyst I
Honolulu,
Hawaii
HMSA
Research and Analysis: Research and respond to low complexity internal and external inquires. Use a variety of resources including, but not limited to on-line information files and databases, peer guidance, interviews with internal departme...
22d
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...
22d