Network Management Representative
Honolulu,
Hawaii
HMSA
a. Responsible for initiating and providing face-to-face support to new providers interested in joining HMSA's network. This includes, but is not limited to, contracting and on-boarding to ensure that there are no unnecessary delays in the ...
11d
Principal System Engineer
Honolulu,
Hawaii
HMSA
Design Solutions: Serve as a technical leader on our most demanding, cross-functional projects. Balance technical leadership with strong business judgment to make the right decisions about technology choices. Decompose complex problems into...
11d
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...
11d
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...
13d
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...
14d
Quality Assurance Trainer II
Kapolei,
Hawaii
HMSA
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 identify training need...
14d
Senior Software Engineer - Data Integration
Honolulu,
Hawaii
HMSA
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 support activities. Lead...
14d
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...
14d
Senior Auditor I
Honolulu,
Hawaii
HMSA
Under the general guidance of the Audit Manager: Perform audit support functions related to risk-based, operational, compliance, financial, and information technology audits, and consulting projects for HMSA. Assist in the execution of audi...
14d
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...
14d