Company:
HMSA
Location: Honolulu
Closing Date: 23/10/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
#LI-Hybrid
- Utilize project management techniques to coordinate focused medical review projects as assigned. Conduct analysis to understand utilization trends. Document and present relative data and recommendations to management and/or oversight committees. Collaborate to implement strategies to improve quality outcomes and control healthcare cost trend in alignment with corporate initiatives.
- Collaborate with reporting SMEs to create reports or dashboards to reflect impact of UM programs as demonstrated by direct cost savings and/or changes in provider behavior. Create and maintain requirements documents for each report or dashboard.
- Identify, research, and resolve issues by making sound decisions in accordance with policies and procedures. Respond to telephone and written inquiries from providers and internal customers. Act as a liaison between Medical Management and internal departments. Build professional relations with various stakeholders
- Create and maintain policy, procedure, and desktop instruction documentation. Assist with education and training to HMSA staff and providers regarding Medical Management activities/projects and seek input and cooperation for the development of new programs.
- Support and participate in department and corporate workgroups and projects, as assigned.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid