Career Opportunities
HMSA is Hawaii’s leading provider of health care coverage. Our success is largely due to the quality and dedication of our employees.
| Jobs: 1 - 10 of 35 |
Nurse Reviewer - Clinical Review Unit
Kapolei, Hawaii
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...
1d
| Job Type | Full Time |
Supervisor, Membership Servicing
Honolulu, Hawaii
Monitor the performance and address issues with any business partners or vendors that supports the Members Servicing Department. Build relationships with both internal and external customers to include members and employer groups to address...
2d
| Job Type | Full Time |
Honolulu, Hawaii
Manage staff, ensuring provider inquiries are responded to timely, accurately, and professionally. Resolve complex provider inquiries. Respond to and oversee staff responding to CMS demand letters. Participate in ad hoc projects to help enh...
2d
| Job Type | Full Time |
Honolulu, Hawaii
Analyzes encounter system processes within HMSA and external partners. Coordinates and reconciles exchange of data with external entities. Researches various claim-member-provider scenarios to determine root cause of data submission errors....
3d
| Job Type | Full Time |
Honolulu, Hawaii
Sustains strong knowledge of encounter system processes within HMSA and external partners. Coordinates and reconciles data exchange with external entities, monitoring quality. Researches complex claim-member-provider scenarios to determine ...
3d
| Job Type | Full Time |
Senior Encounters System Analyst
Honolulu, Hawaii
Sustains mastery of encounter system processes within HMSA and external partners, for multiple lines of business. Monitors trends in data exchange with external entities and recommends adjustments as needed. Researches highly nuanced claim-...
3d
| Job Type | Full Time |
Honolulu, Hawaii
Coordinates various projects as assigned. Develops system requirements, test plan, test scenarios, test cases, anticipated test results and objectives and acceptance criteria. Also, performs testing, communicates status/concerns to appropri...
9d
| Job Type | Full Time |
Honolulu, Hawaii
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...
10d
| Job Type | Full Time |
Performance Reporting Analyst, Command Center
Honolulu, Hawaii
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...
11d
| Job Type | Full Time |
Honolulu, Hawaii
a. 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 u...
11d
| Job Type | Full Time |
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