, to encourage members to attend regular provider appointments, close open care gaps, and utilize medical services that support... service delivery, member satisfaction, cost, and community health. These efforts contribute to better care coordination...
with the state of Hawaii Department of Commerce and Consumer Affairs or pass all four (4) sections of the state licensing... state of Hawaii is a condition of employment. Must have valid driver's license, access to an automobile with current...
, and anomalies. Assess business impact of new edits and changes in medical reimbursement policies/guidelines. Initiate, develop... experience. Two years of related work experience. Understanding of HMSA's business practices, benefit plans, medical...
Job Description: Oversee corporate and department projects, advocating for HMSA consumers while understanding corporate priorities. Lead project phases end-to-end and facilitate business decisions and technical solutions to meet mileston...
Job Description: Strategic Data Analytics and Project Management Understands and aligns enterprise and business unit goals, strategies, and objectives. Works with leadership to identify and prioritize D&A solutions which support goal...
for non-covered or nonparticipating provider services in addition to soliciting claims and other related medical information... to resolve them upon initial inquiry to best service the member as well as minimize the number of cases escalated to senior...
's position and concerns to management and decision makers. Triages cases to resolve them upon initial inquiry to best service...
with Medical Director's guidance Acts as a liaison between vendors and HMSA departments for various audit activities Coordinates...
Job Description: Function as a central communication point between claims processing teams and internal/external partners regarding claim status, issues and resolutions. Investigate and resolve escalated claims and trends, including den...
, including but not limited to, Word, Excel, Outlook, and PowerPoint. Active license with the state of Hawaii Department... date. Having an active license to sell Health, Life and Group Insurance products in the state of Hawaii is a condition...