Healthcare Services Analyst I
4 days ago
- 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 departments including clinical consultants, other Blue Cross/Blue Shield Plans and vendors.
- Benefit and policy analysis & implementation:
- Learns to assess business impact of new benefits, changes in medical or reimbursement policies/guidelines and tactics assigned in strategic planning.
- Learns to conduct cost/benefit analysis of claims processing. Extract and analyze data using SQL, MicroStrategy and/or other tools as available.
- Develop documentation, including cost/benefit and business impact analysis and recommendations to implement and/or improve claims processing.
- Update and create CES pend resolutions.
- Drive implementation of changes through writing of Work Intake Form, participation in multi-department meetings, contribution and review of requirements, validation of test cases, and post-implementation monitoring.
- Focus on low complexity project implementations and pend resolution updates.
- New Code Implementation:
- With the guidance of the Healthcare service analyst II, learns how to load new codes, downloading, processing and importing new codes (CPT, HCPC, ICD-10, etc.).
- Prepare and submit files for review and configuration implementation.
- Review new codes in assigned categories, work with Medical Management and Configuration to ensure appropriate claims processing/editing based on new code review.
- Post-implementation trends and workflow improvements:
- Learn how to support audits of implemented policies and completed projects.
- Identify and investigate areas involving cost increases, uncontrolled payments and/or inequitable payments.
- Identification and resolution of issues and trends as a result of researching and responding to implementation requests, problem reports, and inquiries.
- Develop clear, concise documentation complex business scenarios. This documentation will be used to develop policy/project systems and workflow requirements.
- Continuing Education:
- Attends and successfully completes HMSA and Continuing Education training classes as assigned.
- Other duties as assigned.
- Other
-
Honolulu, Hawaii, United States Pyramid Consulting, Inc Full timeWe are seeking a talented Customer Service Representative I to join our team at Pyramid Consulting, Inc. in Honolulu, HI (Remote).Estimated Salary: $18 - $19 per hourJob Description:This is a 03+months contract opportunity with long-term potential. As a Customer Service Representative I, you will be responsible for:Responding to member/provider...
-
Program Budget Analyst IV
2 days ago
Honolulu, HI, United States Hawai`i State Judiciary Full timeRecruitment Number 24-212TY , Program Budget Analyst IV, SR-22D ($5,258 per month) to SR-22K ($6,922 per month)* , Honolulu, Oahu.*New Salary. The starting salary may be at a rate between the minimum to maximum salary range listed above, based on qualifications. This is a multi-level recruitment. Please see other job postings for:Recruitment Number...
-
Program Budget Analyst V
2 days ago
Honolulu, HI, United States Hawai`i State Judiciary Full timeRecruitment Number 24-213TY , Program Budget Analyst V, SR-24D ($5,918 per month) to SR-24K ($7,787 per month)* , Honolulu, Oahu.*New Salary. The starting salary may be at a rate between the minimum to maximum salary range listed above, based on qualifications. This is a multi-level recruitment. Please see other job postings for:Recruitment Number...
-
Board Certified Behavior Analyst BCBA/ BCaBA
1 month ago
Honolulu, United States Roman Empire ABA Services, Inc. Full timeGreat opportunity to work with an established agency as a BCBA (Board Certified Behavior Analyst) providing ABA therapy for the developmentally disabled.Compensation:* BCBA Rate $60.00-$80.00 per hourBCBA (Board Certified Behavior Analyst) Benefits:* Competitive salary* Health, Vision, Dental* 401K* PTO* Sick Leave* CEU Reimbursement* BACB/State...
-
Healthcare Advocate Specialist
1 week ago
Honolulu, Hawaii, United States Mālama Ola Health Services Full timeJob OverviewMālama Ola Health Services is dedicated to providing compassionate hospice and palliative care to our patients and families. Our mission is to set the standard of excellence for supportive, compassionate healthcare in Hawai`i.About the RoleWe are seeking a skilled Community Health Worker to join our team and support our mission to deliver...
-
Board Certified Behavior Analyst BCBA/ BCaBA
1 week ago
Honolulu, United States Roman Empire ABA Services, Inc. Full time $60 - $80Great opportunity to work with an established agency as a BCBA (Board Certified Behavior Analyst) providing ABA therapy for the developmentally disabled.Please ensure you read the below overview and requirements for this employment opportunity completely.Compensation:* BCBA Rate $60.00-$80.00 per hourBCBA (Board Certified Behavior Analyst) Benefits:*...
-
Multilingual Intelligence Analyst
7 days ago
Honolulu, Hawaii, United States JMark Services Inc. Full timeCompany Overview: JMark Services Inc. is a leading provider of innovative solutions for global intelligence collection and analysis.Salary: The estimated annual salary for this position is $85,000 - $110,000, depending on experience and qualifications.Job Description: We are seeking a highly skilled Multilingual Intelligence Analyst to join our team in...
-
Program Budget Analyst II
1 week ago
Honolulu, United States Hawaii DOT Full timeSalary: Depends on Qualifications Location : Honolulu Job Type: Various Job Number: 24-223TY Department: Policy and Planning Department Opening Date: 11/10/2024 Closing Date: Continuous Position Specific DescriptionRecruitment Number 24-223TY, Program Budget Analyst II, SR-18D ($4,495 per month) to SR-18F ($4,858 per month)*,Honolulu, Oahu. *The starting...
-
Threat Analyst
3 days ago
Honolulu, United States JMark Services Inc. Full timeJMark Services Inc. seeks to hire uniquely and highly qualified personnel to meet the growing needs of our customers worldwide. As a successful small business, we recognize that our employees are our most valuable resource. We proudly offer a comprehensive benefits package along with support and commitment to the success and welfare of each employee who...
-
Budget Analyst
1 week ago
Honolulu, United States Booz Allen Hamilton Full timeJob Number: R0205197Budget AnalystThe Opportunity: The right mixture of great ideas and funding can create change. In a complex organization, allocating funding to where it can be most effective can be challenging. That‘s why we need you, a budget analyst who can easily navigate the requirements, policies, and regulations that govern funding, to make sure...
-
Customer Relations Program Analyst I
1 week ago
Honolulu, United States HMSA Full timeImplementation Support and Solution Evaluation: Reviews the solution design to ensure it fulfills all requirements. Identifies opportunities to meet additional business needs within the scope of the project. Participates in the testing and monitoring of system or process changes and supports the implementation efforts by providing content knowledge as...
-
Customer Relations Program Analyst I
4 hours ago
Honolulu, United States HMSA Full timeImplementation Support and Solution Evaluation: Reviews the solution design to ensure it fulfills all requirements. Identifies opportunities to meet additional business needs within the scope of the project. Participates in the testing and monitoring of system or process changes and supports the implementation efforts by providing content knowledge as...
-
Analyst
1 week ago
Honolulu, United States Booz Allen Hamilton Full timeJob Number: R0204834Project Controls AnalystThe Opportunity: The right mixture of great ideas and attention to detail skillset can create powerful change. In a complex organization, allocating resources to where they can be most effective can be a challenge. That‘s why we need you, an experienced financial analyst who can help support a team in navigating...
-
Honolulu, Hawaii, United States Always Best Care Senior Services - Oahu Full timeJob DescriptionWe are seeking experienced Nurses to provide care and support to seniors in their homes. Our organization, Always Best Care Senior Services - Oahu, offers a range of healthcare services to assist individuals with daily living activities.Key responsibilities include:Providing hands-on care and assistance with daily activitiesDeveloping and...
-
Maritime Domain Awareness Analyst
6 months ago
Honolulu, United States Kavaliro Full timeKavaliro is seeking a Senior Intelligence Analyst aligned with geographic regions at our client site to assist in providing Steady-State, Crisis, and Predictive Intelligence coverage of the assigned region, facilitating both CONOP development and support for various divisions and interagency planning to develop a full range of options. The Senior...
-
SIGINT Geospatial Analyst
3 days ago
Honolulu, United States Clear Resolution Consulting, LLC Full timeOPPORTUNITIES TO IGNITE YOUR PASSION, CRC services include Intelligence Analysis, Business Management, Cyber Operations, and Information Technology Consulting Services to the Department of Defense (DoD), Intelligence Community (IC) and other Federal Agencies. We offer a wide range of career opportunities and exceptional benefits. JOB SUMMARY: CRC is in need...
-
Customer Relations Program Analyst I
1 month ago
Honolulu, United States Hawaii Medical Service Association Full timeImplementation Support and Solution Evaluation: Reviews the solution design to ensure it fulfills all requirements. Identifies opportunities to meet additional business needs within scope of the project. Participates in the testing and monitoring of system or process changes and supports the implementation efforts by providing content knowledge as needed....
-
Imagery Analyst
1 week ago
Honolulu, United States Booz Allen Hamilton Full timeJob Number: R0210431GEOINT and Imagery AnalystThe Opportunity: With cloud-based tools, faster GPUs, and the explosion of connected devices, geospatial data has more potential than ever. A skilled geospatial and remote sensing analyst can turn that data into mission critical information. If that sounds like you, we have an opportunity for you to use your...
-
Veterinary Services Assistant I
2 months ago
Honolulu, United States Hawaiian Humane Society Full timeJOB/POSITION TITLE: Veterinary Services Assistant I (VSAI)STATUS: Non-exemptPRIMARY PURPOSE: Provides assistance to Veterinary Services team members who perform assessment and healthcare of all animals, technical support for sterilization surgeries, medical treatment and humane euthanasia.Reports To: Veterinary Services ManagerSupervises: Volunteers as...
-
Healthcare Services Director
7 days ago
Honolulu, Hawaii, United States Always Best Care Senior Service Full timeJob SummaryWe are looking for a skilled Senior Care Coordinator Supervisor to manage our sales team and provide exceptional customer service. This role involves developing and implementing marketing strategies to promote our services to local healthcare providers and businesses.