specific eligibility, benefit and provider requirement for selected service(s) based on member's primary line of business... validation of member specific eligibility, benefit and provider requirement for selected service(s) based on member's primary...
Job Description: Program and Project Management: Responsible for strategic and tactical planning of HMSA's approach to delivering excellent performance and value for Federal Plan 87/Postal Plan and providing clear leadership, trainin...
Job Description: Be the in-office service contact for assigned groups. Resolves day-to-day servicing inquiries... about benefits for medical, drug and dental lines of business, claims processing knowledge to work with Customer Relations...
Job Description: For assigned line(s) of business, the Lead Actuarial Analyst will: * Lead the pricing and rating of HMSA's products, including the following: Collecting and analyzing historical experience data, developing projections ...
Collaborate with Medical Management on utilization and clinical FWA risks Coordinate with Provider Relations on provider actions...
Job Description: Handles employee relations related inquiries and conducts thorough and timely investigations into employee concerns on HR matters. Supports investigative processes from beginning to end including complainant intakes, in...
Job Description: In-office service contact for assigned groups. Handles day-to-day servicing inquiries directly...
Job Description: Manage and lead a membership admin team by providing training, mentorship, and best practice solutions. Manage daily operations of the membership admin team, including inventory analysis, tracking and resolution Serve ...
Job Description: Assessment Triage member to identify medical, psychological, and social barriers to discharge... call cadence Refers to TCN for medical needs and CHW for community needs. Performs all other miscellaneous...
Job Description: Performance Proactively service and grow HMSA products and services through various methods... arrangements to the large group market segment. Responsible for being the primary contact for all complex existing account service...