Transition of Care Specialist I HMSA

This position is responsible for development and implementation of transitional care support for members in inpatient or residential settings stratified as low complexity care management needs in Medicaid, Medicare, and Whole Health markets. Supports members enrolled in Care Management while in a higher level of care facility, along with facilitating member...

CUSTOMER INTERACTIONDeliver an outstanding customer-centric experience at the HMSA Center. Strive to meet and surpass customer expectations while effectively communicating HMSA's dedication to service excellence.Foster lasting relationships with HMSA's members and other consumers by acting as their reliable advisor, ensuring commitments are...

Quality Improvement LeadershipLead and oversee HMSA's comprehensive Quality Improvement initiatives, ensuring alignment with accreditation, regulatory, and program standards (e.g., NCQA, Med-QUEST, CMS, OPM, etc.). Direct project teams and provide expert guidance throughout the phases of planning, development, execution, and assessment to guarantee that...

Monitor, track and analyze legislation introduced at the state levelGenerate weekly Executive Summary Report of key legislation. Develop and distribute weekly updates to HMSA executive staff throughout the legislative session. Monitor legislative hearings and meetings as needed. Conduct legislative research and compile summary reports on state and national...

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 units or departments to find a solutionAccurately updating member recordsContacting external partners who provide services...

Find out if this opportunity is a good fit by reading all of the information that follows below.aProject management and facilitation Develops and maintains project plans, timelines, and scope documents for strategy initiatives.Proactively manages deliverables, timelines, and budget:Monitors and takes appropriate action to ensure various task and...

Position OverviewCompensation Range: $51,124- $74,293 In alignment with the mission and vision of HMSA, this role is dedicated to the design and implementation of impactful training initiatives for the Customer Relations team. The focus will be on identifying departmental needs and addressing skill gaps through tailored coaching and consulting.Essential...

Responsible for all aspects of the quality program for a business unit within a Strategic Business Unit (SBU) including strategic planning, program development and leadership, and staffing. Serves as a member of the management team in designing, implementing, and monitoring quality operations with well defined processes and uses performance measurement as...

This role is onsite. Ideal candidate will need to reside in Hawaii.Customer advocate role supporting our members and providers, facilitating care and service. This is a service position providing assistance to Magellan's members, providers, and clients regarding various aspects of our programs, policies, and procedures. Responsibilities include handling...

Job Summary: Hybrid Work Environment - Must reside on Oahu To provide care coordination for eligible HMSA members and facilitate a collaborative relationship among members, providers, community agencies and HMSA staff to ensure members receive timely and integrated access to services. Case Managers/Health Coordinators with Implementing the health action...

Software Configuration and Release Management SpecialistWe are seeking a dedicated Software Configuration and Release Management Specialist to contribute to our projects. This role is crucial for managing intricate software development initiatives. The ideal candidate should possess a Bachelor's degree in computer science or a related discipline, along with...

Position OverviewThe role of the Care Worker UM at Magellan Health Services is pivotal in enhancing departmental efficiency by providing essential administrative support to the clinical team. This position is responsible for:Identifying and connecting enrollees with community resources and referral services, ensuring seamless access to care.Facilitating...

Develop, analyze, recommend, and monitor reimbursement and provider strategies; prepare reports that measure the effectiveness of reimbursement and contracting terms and the influence they may have on overall program/plan cost and utilization. Analyze data and identify trends, patterns, or other notable issues with an eye for cost reduction opportunities....

Position Title: Credit Union Operations SupervisorKey Responsibilities:Support the Director in executing Credit Union policies and operational procedures that align with financial targets and strategic objectives.Coordinate board meetings, annual gatherings, and strategic planning initiatives.Facilitate training and development programs for staff to improve...

Software Configuration and Release Management ExpertWe are looking for a Software Configuration and Release Management Expert to contribute to our projects. This role is essential for overseeing complex initiatives and requires a solid foundation in Configuration Management practices. Candidates should possess a Bachelor's degree in computer science or a...

Software Configuration and Release Management ProfessionalWe are seeking a dedicated Software Configuration and Release Management Professional to contribute to our projects. This role requires involvement in intricate projects as a vital member of the project team. The ideal candidate should possess a Bachelor's degree in computer science or a related...

Job Overview**Hybrid Work Setting - Must be a Hawaii Resident **Compensation Range: $59,000 - $116,000 Note: Typically, individuals start between the lower to mid-range of the salary scale.Oversee the investment accounting responsibilities for HMSA in accordance with Generally Accepted Accounting Principles (GAAP), the State of Hawaii regulations, and...

Position Overview:This announcement is intended to recruit for various Instructional Support Specialist roles within the designated area. The highest level of these roles is Instructional Support Specialist III, with applications being accepted for lower levels (I and II) in case of recruitment challenges.Compensation:Instructional Support Specialist I,...

Job SummaryThe Wilson Care Group is seeking a skilled Care Specialist to join our team. As a Nursing Consultant, you will be responsible for conducting thorough assessments, developing personalized care plans, and overseeing the delivery of high-quality care to our clients.Key Responsibilities:Conduct comprehensive assessments to identify client needs and...

Recruitment Number 24-092TY, Forensic Interview Specialist (DL), SR-22 , Honolulu, O ahu.Apply (by clicking the relevant button) after checking through all the related job information below.Salary rate effective July 1, 2024Note: This position requires a current and valid driver's license to operate a motor vehicle.Conducts developmentally appropriate, video...