Jobs at HMSA (Now Hiring) — 18 open

Senior, Manager, Provider and Facility Contracting

Honolulu, Hawaii, United States · Hybrid

Senior

Manage CFR Team You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These respo…

Skills: Contract Negotiation, Provider Services Management, Strategic Planning, Personnel Management, Regulatory Compliance

HMSA

Strategic Program Manager, Medicaid P&L

Honolulu, Hawaii, United States · On-site

Senior

Financial Performance Management & Business Planning Leads program-level financial performance routines (budget tracking, variance drivers, and corrective action plans). Develops business cases and financial impact asses…

Skills: Financial Performance Management, Business Planning, Budget Tracking, Business Case Development, Project Management

HMSA

Manager, Accounting

Honolulu, Hawaii, United States · Hybrid

Senior

Oversee and manage accounting operations for HMSA and its subsidiaries, including general ledger and reconciliation activities. Streamline processes and implement efficiencies to optimize financial operations. Ensure acc…

Skills: General Ledger, Financial Reconciliation, GAAP, SAP, Financial Analysis

HMSA

Senior Financial Health Care Data Analyst III

Honolulu, Hawaii, United States · Hybrid

Senior

Facilitates complex projects and functions of high importance as an independent project lead. Plans and manages the project development process and oversees implementation. Analyzes intricate project objectives, data sou…

Skills: Data Reporting, Data Analysis, Project Management, Managed Care, Healthcare Business Processes

HMSA

Senior Manager, Provider Reimbursements

Honolulu, Hawaii, United States · Hybrid

Senior

Oversee management and staff responsible for implementation and administration of Provider Reimbursement methodologies, including, but not limited to: Institutions, Professionals, and ancillary providers. Provide managem…

Skills: Provider Reimbursement, Financial Reporting, Data Analysis, Project Management, Staff Management

HMSA

Quality Assurance Trainer I - Bluecard

Kapolei, Hawaii, United States · Hybrid

Entry level

Conducts audits in the operational areas to include: Monthly audits to monitor controls and performance. Document and review findings with operational staff and management. Track audit results and spot error trends to id…

Skills: Quality Assurance, Auditing, Training Documentation, Medical Terminology, Health Industry Coding

HMSA

Lead System Analyst

Honolulu, Hawaii, United States · Hybrid

Senior

Cross-Functional Project Team Leadership and Participation: Lead project staff and subject matter experts with the planning and implementation of project and sub-project work efforts. Lead, coordinate, facilitate, and/or…

Skills: Project Leadership, Business Requirements Gathering, Data Analysis, Data Governance, Workflow Design

HMSA

Care Manager, Medicare Stars

Honolulu, Hawaii, United States · Hybrid

Mid level

Assessment & Planning May conduct comprehensive assessments, which could include physical, psychosocial, and health literacy evaluation, and interprets relevant diagnostic data to identify member and family needs. Apply …

Skills: Comprehensive Assessment, Care Planning, Medication Reconciliation, Care Gap Closure, Quality Improvement

HMSA

Healthcare Services Analyst I

Honolulu, Hawaii, United States · On-site

Entry level

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 wi…

Skills: Research and Analysis, SQL, MicroStrategy, Cost/Benefit Analysis, Claims Processing

HMSA

Application Lead

Honolulu, Hawaii, United States · Hybrid

Senior

Maintaining Application Systems Prioritizes and coordinates application support efforts. Updates management on escalated issues on a regular basis. Supports and maintains Production incidents tracking on a daily basis by…

Skills: Application Support, ServiceNow, Resource Planning, Service Level Agreements, Strategic Planning

HMSA

Senior Software Engineer

Honolulu, Hawaii, United States · Hybrid

Senior

Responsible for analysis, design, modeling and architecture for application systems and domains. Manages the maintenance and support of assigned application system(s). May participate in development, maintenance and supp…

Skills: Application Architecture, Systems Analysis, Software Design, Project Planning, Technical Specifications

HMSA

Assistant Vice President, Enterprise Architecture and Cloud Operations

Honolulu, Hawaii, United States · Hybrid

Senior+

Stakeholder Engagement Builds and sustains strong relationships with executive leaders, business partners, and external stakeholders to advance strategic priorities and enterprise alignment. Evaluates complex business ch…

Skills: Enterprise Architecture, Cloud Operations, Business Architecture, Stakeholder Engagement, Strategic Leadership

HMSA

Medicare Sales Producer

Honolulu, Hawaii, United States · On-site

Mid level

Sales Activities: Meet established marketing plan goals and achieve annual sales revenue and membership growth objectives by effectively promoting and closing prospective sales opportunities. Must generate robust sales a…

Skills: Sales, Medicare Advantage, Lead Generation, Customer Relationship Management, Public Speaking

HMSA

Administrative Coordinator

Honolulu, Hawaii, United States · Hybrid

Mid level

Administrative Assistance Exercises good decision making and independent judgment in relieving the assigned leader of all administrative detail, ensuring the most effective use of the leader's attention and focus by: Mai…

Skills: Calendar Management, Confidentiality, Meeting Coordination, Presentation Preparation, Budget Monitoring

HMSA

Supervisor, Health Plan Education & Group Well-Being Plans

Honolulu, Hawaii, United States · Hybrid

Senior

Develop goals and objectives for performance management program to ensure maximum performance of staff. Provide guidance, coaching and mentoring through the performance management process. Ensure staff remains committed …

Skills: Performance Management, Staff Coaching, Strategic Planning, Open Enrollment Coordination, Public Speaking

HMSA

Customer Service and Sales Representative

Kapolei, Hawaii, United States · Hybrid

Mid level

Performance Meet established marketing plan goals, and achieve annual sales revenue and membership growth objectives by effectively promoting and closing prospective sales opportunities. Perform quick and efficient trans…

Skills: Sales, Customer Service, Account Management, Insurance Licensing, Proposal Preparation

HMSA

Medical Management Policy & Research Analyst I

Honolulu, Hawaii, United States · Hybrid

Entry level

Revise and/or develop medical policies adopted from the BCBSA in conjunction with assigned medical director and in accordance with Development and Approval of Medical Policy administrative policy; process includes approp…

Skills: Medical Policy Development, Research, Communication Skills, Organizational Skills, Time Management

HMSA

Manager, Encounter Submissions

Honolulu, Hawaii, United States · Hybrid

Senior

Encounter Submissions Management Communicates with LOB leads and Governance Finance Director on the necessary information and context for strategic business decision making. Establishes schedule for meetings and delivera…

Skills: Encounter Submissions Management, Program Management, Team Leadership, Data Reconciliation, Risk Adjustment

Senior, Manager, Provider and Facility Contracting

HMSA

Honolulu, Hawaii, United States • Hybrid

Apply

Senior

Tired of cold applications?

Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.

Full-time
bachelor degree
Posted 1d ago
~40 hrs/week

Responsibilities

Lead the Provider and Facility Contracting team by overseeing daily operations, managing staff, and ensuring regulatory compliance. Develop and implement provider strategies and maintain strategic partnerships with hospital administrators and physician leadership.

Requirements

Requires a bachelor's degree and at least six years of related experience, including two years in a supervisory role. Candidates must have experience in contract negotiation and working within highly regulated industries.

Full job description

Manage CFR Team
- You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These responsibilities include, but are not limited to, the following:
- Leadership. Provide direction and guidance to staff on provider issues continually reinforcing partnership and alignment to company and department values and goals. Hold staff accountable to meet commitments, including regularly monitoring and overseeing work to ensure that it is being done timely, and that the department is producing high quality work. Responsibilities also include (1) reviewing and providing guidance to staff for contract negotiations, (2) providing and/or coordinating training for Provider Services staff responsible for contracting operations, and (3) working with other HMSA departments (Compliance and Ethics, government LOBs, etc.) to ensure legal and regulatory compliance of provider contracting function within HMSA.
- Teaming. Build and sustain a high performing provider contracting team. Attract and retain the best talent to meet current and future business needs; develop people to meet both their career goals and the company's goals.
- Managing execution. Provide direction, delegate and remove obstacles to get work done. Plan and prioritize work to meet commitments aligned with organizational goals. Identify areas of development for direct reports and provide development opportunities; assign tasks as appropriate; review, monitor, and provide feedback for continual improvement.
- Oversee CFR operations. Oversee and manage operations of CFR department, including
  - Managing the day to day operations of the department,
  - Overseeing personnel, developing and communicating performance measures, conducting periodic reviews, and determining salary changes or other increases in compensation
  - Hiring and when necessary dismissing employees for non-performance, and,
  - Managing contract management and provider contracting operations (accuracy of eVIPs contract record and data entry, system testing, accurate payment outcomes/terms, contract negotiation schedules/timelines, contract timeline ticklers, contract oversight and compliance) to mitigate risk to HMSA and ensure business continuity.
- Compliance. Ensure provider contracts and policies considered an extension of provider contracts within the unit's scope are administered properly by HMSA, including alignment of contractual terms with claims processing, utilization management and appeals. Coordinate internally with other HMSA departments (such as Professional Reimbursement, Claims Administration, Medical Management, BCIS Configuration, Legal, Compliance, and Marketing and Communications, etc.) as needed. Includes contractual compliance to HMSA business, rules/regulations, laws, program requirement.
Provider Strategy
- Aligned with HMSA mission, vision, values and provider strategy, responsible
  for participating in the development, support and implementation of HMSA's overall provider strategy, including contracting strategy as to hospitals and negotiated and facility contracting. This includes, but is not limited to the following:
- Close participation in various corporate strategy initiatives touching providers, including ACO and other value based arrangements, payment transformation and strategic vendor or quasi-provider relationships.
- Ensure that staff responsible for negotiated and facility contracting are informed and aligned with corporate strategy and initiatives.
- Identify the need for, and coordinate the development of, new contracts and new contracting strategies as required by the ever changing needs of the provider community and HMSA's strategic and tactical initiatives
Provider Partnership
- Aligned with HMSA mission, vision, values and provider strategy, responsible
  for developing and maintaining partnerships with strategic provider partners.
- This includes, but is not limited to the following:
  - Conducting provider contracting negotiations.
  - Developing and maintaining positive working relationships with hospital administrators, financial management staff, physician organization leadership, and quality improvement staff.
  - Representing Provider Services on cross-functional projects and teams.
  - As needed, work directly on corporate initiatives including strategic provider initiatives, provide guidance on contract matters to supervisors or other operational staff, including training to new project stakeholders and other employees in contracting practices and procedures.
Perform all other miscellaneous responsibilities and duties as assigned or directed.

#LI-Hybrid

Qualifications

Bachelor's degree and six years of related work experience, or an equivalent combination of education and work experience.
Two years of previous management/supervisory experience.
Experience with a highly regulated industry.
Experience negotiating contracts and/or vendor/contract management.
Communicate clearly and concisely, both verbally and in writing. Establish and maintain effective working relationships with those contacted in the course of work.
Excellent interpersonal skills.
Strong analytical skills.
Strong leadership skills.
Strong planning and organization skills.
Excellent supervisory/management skills.
Excellent leadership skills.
Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, Outlook, and Power Point.

Related keywords

Provider ContractingFacility ContractingCFR TeamValue Based ArrangementsACOPayment TransformationHealthcare AdministrationContract ManagementComplianceMedical ManagementClaims AdministrationeVIPsProvider StrategyHealthcare Regulation

About HMSA

LinkedIn Visit site

Improving the lives of our members and the health of Hawaii. #hmsahawaii #teamhmsa

Industry: Insurance
Company size: 1,001-5,000 employees
Founded: 1938
Headquarters: Honolulu, Hawaii
LinkedIn followers: 11,003

The Hawaii Medical Service Association (HMSA), an independent licensee of the Blue Cross and Blue Shield Association, is a reliable name in Hawaii health care. Established in 1938, we are the largest and most experienced provider of health care coverage in the state. Over half of Hawaii’s population have chosen HMSA for their health care coverage. We are dedicated to providing quality, affordable health plans; employee benefit services; and worksite wellness programs. HMSA also offers a variety of programs, services and support to help improve the health and well-being of our members and community.

Offices: 818 Keeaumoku Street, Honolulu, Hawaii 96814, US

Health CareInsuranceMedicalAssociation

View all jobs at HMSA

About HMSA

LinkedIn Visit site

Improving the lives of our members and the health of Hawaii. #hmsahawaii #teamhmsa

Industry: Insurance
Company size: 1,001-5,000 employees
Founded: 1938
Headquarters: Honolulu, Hawaii
LinkedIn followers: 11,003

Offices: 818 Keeaumoku Street, Honolulu, Hawaii 96814, US

Health CareInsuranceMedicalAssociation

View all jobs at HMSA

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Jobs at HMSA (Now Hiring) — 18 open

HMSA

Senior, Manager, Provider and Facility Contracting

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: Contract Negotiation, Provider Services Management, Strategic Planning, Personnel Management, Regulatory Compliance

HMSA

Strategic Program Manager, Medicaid P&L

Honolulu, Hawaii, United States · On-site

Senior

Skills: Financial Performance Management, Business Planning, Budget Tracking, Business Case Development, Project Management

HMSA

Manager, Accounting

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: General Ledger, Financial Reconciliation, GAAP, SAP, Financial Analysis

HMSA

Senior Financial Health Care Data Analyst III

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: Data Reporting, Data Analysis, Project Management, Managed Care, Healthcare Business Processes

HMSA

Senior Manager, Provider Reimbursements

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: Provider Reimbursement, Financial Reporting, Data Analysis, Project Management, Staff Management

HMSA

Quality Assurance Trainer I - Bluecard

Kapolei, Hawaii, United States · Hybrid

Entry level

Skills: Quality Assurance, Auditing, Training Documentation, Medical Terminology, Health Industry Coding

HMSA

Lead System Analyst

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: Project Leadership, Business Requirements Gathering, Data Analysis, Data Governance, Workflow Design

HMSA

Care Manager, Medicare Stars

Honolulu, Hawaii, United States · Hybrid

Mid level

Skills: Comprehensive Assessment, Care Planning, Medication Reconciliation, Care Gap Closure, Quality Improvement

HMSA

Healthcare Services Analyst I

Honolulu, Hawaii, United States · On-site

Entry level

Skills: Research and Analysis, SQL, MicroStrategy, Cost/Benefit Analysis, Claims Processing

HMSA

Application Lead

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: Application Support, ServiceNow, Resource Planning, Service Level Agreements, Strategic Planning

HMSA

Senior Software Engineer

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: Application Architecture, Systems Analysis, Software Design, Project Planning, Technical Specifications

HMSA

Assistant Vice President, Enterprise Architecture and Cloud Operations

Honolulu, Hawaii, United States · Hybrid

Senior+

Skills: Enterprise Architecture, Cloud Operations, Business Architecture, Stakeholder Engagement, Strategic Leadership

HMSA

Medicare Sales Producer

Honolulu, Hawaii, United States · On-site

Mid level

Skills: Sales, Medicare Advantage, Lead Generation, Customer Relationship Management, Public Speaking

HMSA

Administrative Coordinator

Honolulu, Hawaii, United States · Hybrid

Mid level

Skills: Calendar Management, Confidentiality, Meeting Coordination, Presentation Preparation, Budget Monitoring

HMSA

Supervisor, Health Plan Education & Group Well-Being Plans

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: Performance Management, Staff Coaching, Strategic Planning, Open Enrollment Coordination, Public Speaking

HMSA

Customer Service and Sales Representative

Kapolei, Hawaii, United States · Hybrid

Mid level

Skills: Sales, Customer Service, Account Management, Insurance Licensing, Proposal Preparation

HMSA

Medical Management Policy & Research Analyst I

Honolulu, Hawaii, United States · Hybrid

Entry level

Skills: Medical Policy Development, Research, Communication Skills, Organizational Skills, Time Management

HMSA

Manager, Encounter Submissions

Honolulu, Hawaii, United States · Hybrid

Senior

Skills: Encounter Submissions Management, Program Management, Team Leadership, Data Reconciliation, Risk Adjustment

Senior, Manager, Provider and Facility Contracting

HMSA

Honolulu, Hawaii, United States • Hybrid

Apply

Senior

Tired of cold applications?

Sign up with Clera and we'll reach out the moment a role actually fits you — no more spraying applications into the void.

Full-time
bachelor degree
Posted 1d ago
~40 hrs/week

Responsibilities

Requirements

Full job description

Manage CFR Team
- You are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in the CFR department as well as outside contracted vendors. These responsibilities include, but are not limited to, the following:
- Leadership. Provide direction and guidance to staff on provider issues continually reinforcing partnership and alignment to company and department values and goals. Hold staff accountable to meet commitments, including regularly monitoring and overseeing work to ensure that it is being done timely, and that the department is producing high quality work. Responsibilities also include (1) reviewing and providing guidance to staff for contract negotiations, (2) providing and/or coordinating training for Provider Services staff responsible for contracting operations, and (3) working with other HMSA departments (Compliance and Ethics, government LOBs, etc.) to ensure legal and regulatory compliance of provider contracting function within HMSA.
- Teaming. Build and sustain a high performing provider contracting team. Attract and retain the best talent to meet current and future business needs; develop people to meet both their career goals and the company's goals.
- Managing execution. Provide direction, delegate and remove obstacles to get work done. Plan and prioritize work to meet commitments aligned with organizational goals. Identify areas of development for direct reports and provide development opportunities; assign tasks as appropriate; review, monitor, and provide feedback for continual improvement.
- Oversee CFR operations. Oversee and manage operations of CFR department, including
  - Managing the day to day operations of the department,
  - Overseeing personnel, developing and communicating performance measures, conducting periodic reviews, and determining salary changes or other increases in compensation
  - Hiring and when necessary dismissing employees for non-performance, and,
  - Managing contract management and provider contracting operations (accuracy of eVIPs contract record and data entry, system testing, accurate payment outcomes/terms, contract negotiation schedules/timelines, contract timeline ticklers, contract oversight and compliance) to mitigate risk to HMSA and ensure business continuity.
- Compliance. Ensure provider contracts and policies considered an extension of provider contracts within the unit's scope are administered properly by HMSA, including alignment of contractual terms with claims processing, utilization management and appeals. Coordinate internally with other HMSA departments (such as Professional Reimbursement, Claims Administration, Medical Management, BCIS Configuration, Legal, Compliance, and Marketing and Communications, etc.) as needed. Includes contractual compliance to HMSA business, rules/regulations, laws, program requirement.
Provider Strategy
- Aligned with HMSA mission, vision, values and provider strategy, responsible
  for participating in the development, support and implementation of HMSA's overall provider strategy, including contracting strategy as to hospitals and negotiated and facility contracting. This includes, but is not limited to the following:
- Close participation in various corporate strategy initiatives touching providers, including ACO and other value based arrangements, payment transformation and strategic vendor or quasi-provider relationships.
- Ensure that staff responsible for negotiated and facility contracting are informed and aligned with corporate strategy and initiatives.
- Identify the need for, and coordinate the development of, new contracts and new contracting strategies as required by the ever changing needs of the provider community and HMSA's strategic and tactical initiatives
Provider Partnership
- Aligned with HMSA mission, vision, values and provider strategy, responsible
  for developing and maintaining partnerships with strategic provider partners.
- This includes, but is not limited to the following:
  - Conducting provider contracting negotiations.
  - Developing and maintaining positive working relationships with hospital administrators, financial management staff, physician organization leadership, and quality improvement staff.
  - Representing Provider Services on cross-functional projects and teams.
  - As needed, work directly on corporate initiatives including strategic provider initiatives, provide guidance on contract matters to supervisors or other operational staff, including training to new project stakeholders and other employees in contracting practices and procedures.
Perform all other miscellaneous responsibilities and duties as assigned or directed.

#LI-Hybrid

Qualifications

Bachelor's degree and six years of related work experience, or an equivalent combination of education and work experience.
Two years of previous management/supervisory experience.
Experience with a highly regulated industry.
Experience negotiating contracts and/or vendor/contract management.
Communicate clearly and concisely, both verbally and in writing. Establish and maintain effective working relationships with those contacted in the course of work.
Excellent interpersonal skills.
Strong analytical skills.
Strong leadership skills.
Strong planning and organization skills.
Excellent supervisory/management skills.
Excellent leadership skills.
Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, Outlook, and Power Point.

Related keywords

About HMSA

LinkedIn Visit site

Improving the lives of our members and the health of Hawaii. #hmsahawaii #teamhmsa

Industry: Insurance
Company size: 1,001-5,000 employees
Founded: 1938
Headquarters: Honolulu, Hawaii
LinkedIn followers: 11,003

Offices: 818 Keeaumoku Street, Honolulu, Hawaii 96814, US

Health CareInsuranceMedicalAssociation

View all jobs at HMSA

About HMSA

LinkedIn Visit site

Improving the lives of our members and the health of Hawaii. #hmsahawaii #teamhmsa

Industry: Insurance
Company size: 1,001-5,000 employees
Founded: 1938
Headquarters: Honolulu, Hawaii
LinkedIn followers: 11,003

Offices: 818 Keeaumoku Street, Honolulu, Hawaii 96814, US

Health CareInsuranceMedicalAssociation

View all jobs at HMSA

Jobs at HMSA (Now Hiring) — 18 open

Senior, Manager, Provider and Facility Contracting

Strategic Program Manager, Medicaid P&L

Manager, Accounting

Senior Financial Health Care Data Analyst III

Senior Manager, Provider Reimbursements

Quality Assurance Trainer I - Bluecard

Lead System Analyst

Care Manager, Medicare Stars

Healthcare Services Analyst I

Application Lead

Senior Software Engineer

Assistant Vice President, Enterprise Architecture and Cloud Operations

Medicare Sales Producer

Administrative Coordinator

Supervisor, Health Plan Education & Group Well-Being Plans

Customer Service and Sales Representative

Medical Management Policy & Research Analyst I

Manager, Encounter Submissions

Senior, Manager, Provider and Facility Contracting

Tired of cold applications?

Responsibilities

Requirements

Full job description

Related keywords

About HMSA

About HMSA

Similar companies hiring

Tools

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Jobs at HMSA (Now Hiring) — 18 open

Senior, Manager, Provider and Facility Contracting

Strategic Program Manager, Medicaid P&L

Manager, Accounting

Senior Financial Health Care Data Analyst III

Senior Manager, Provider Reimbursements

Quality Assurance Trainer I - Bluecard

Lead System Analyst

Care Manager, Medicare Stars

Healthcare Services Analyst I

Application Lead

Senior Software Engineer

Assistant Vice President, Enterprise Architecture and Cloud Operations

Medicare Sales Producer

Administrative Coordinator

Supervisor, Health Plan Education & Group Well-Being Plans

Customer Service and Sales Representative

Medical Management Policy & Research Analyst I

Manager, Encounter Submissions

Senior, Manager, Provider and Facility Contracting

Tired of cold applications?

Responsibilities

Requirements

Full job description

Related keywords

About HMSA

About HMSA

Similar companies hiring

Tools

Explore

Company