Business Analyst, Medicare Stars
3 weeks ago
- Quality Improvement Interventions Analysis and Development:
- Work as part of the Stars team to continuously identify, plan, develop, implement, and evaluate interventions.
- Develop reports, analyses, and data mining to support program planning and interventions.
- Complete program and initiative evaluations such as return on investment and health outcomes.
- Apply detailed analysis and problem solving to research and recognize trends to assess need and identify opportunities for quality improvement.
- Gather and synthesize research studies, Stars industry information, and BCBSA resources to gain insight and apply best practices to health care quality improvement strategies.
- Conduct data analysis to support projects and interventions, including gathering data, analyzing data, and presenting recommendations.
- Program and Project Management:
- Plan and implement multiple cross-departmental programs and project(s) with guidance from program managers, executive sponsors, subject matter experts, and project staff.
- Define project scope and schedule by working with business area leads and develop project plans; including tasks, deliverables, and expected outcomes/goals.
- Develop and facilitate full project documentation and reporting to meet identified goals and objectives of each project.
- Proactively monitor overall project performance and life cycle (e.g., on time, within scope and with quality) against measure plans/dashboards and adjust as needed.
- Manage and track risks and issues to completion.
- Organize and lead project status and working meetings.
- Work directly with cross-departmental team members to facilitate communication. Prepare and provide status updates and reports to business owners, executive sponsors, partners, project teams, and others as required.
- Assist with tracking project expenses.
- Generate requirements, reports, and operational processes.
- Complete program and project evaluations, including accomplishments, outcomes, barriers, and opportunities.
- Cross-Functional Integration and Communication:
- Work with HMSA departments and external partners to collect and distribute information, complete tasks, facilitate communication, and provide status updates to ensure coordination among groups.
- Communicate analysis, assessments, recommendations and completed work product by creating and delivering written and verbal reports and presentations to quality committees and other internal and external stakeholders.
- Quality Improvement Program Support:
- Complete work and documentation to support completion of activities and documentation for the annual Quality Improvement Evaluation and Workplan.
- Support completion of required reporting and quality improvement plans.
- Coordinate, facilitate and conduct medical record reviews to support quality activities
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid
-
Medicare Business Analyst
1 week ago
Honolulu, United States Dice Full timeDice is the leading career destination for tech experts at every stage of their careers. Our client, TEKsystems c/o Allegis Group, is seeking the following. Apply via Dice today! Hello, one of Hawaii's largest Healthcare organizations is looking for a Medicare Business Analyst to join their team for a new healthcare plan implementation. Healthcare experience...
-
Medicare Part D Business Analyst
1 month ago
Honolulu, United States CareerBuilder Full timeJob Summary Hybrid Work Environment - Must reside in Hawaii ** Function as a business analyst for programs, projects, and other related tactical initiatives by helping to guide project teams and operational units in their planning, research, analysis, project management and communication efforts necessary to develop, modify and implement successful programs....
-
Provider Operations Business Analyst
4 weeks ago
Honolulu, United States HMSA Full timeJob Summary The Provider Operations Business Analyst will be responsible for performance monitoring, research, analysis, development, implementation and coordination of Provider Operation's initiatives and related projects to ensure the highest integrity of HMSA's Provider Network data, credentialing, directories, and related operational functions. This...
-
Manager, Medicare Programs
1 week ago
Honolulu, United States HMSA Full timeLeadership Identify, initiate, and manage organization-wide projects to ensure that all HMSA's Medicare Program contractual obligations are met or exceeded. Manages necessary changes to existing systems, operations or workflows to address new/revised requirements of CMS/DHS/MQD. Structures work plans and project scope to deliver business impact on high...
-
Programs Analyst
7 days ago
Honolulu, Hawaii, United States ALTRES Staffing Full timePrograms Analyst (medical A reputable health insurance company is seeking a Program Analyst to join their team and assist with Medicare and Medicaid related issues such as fraud, abuse, and audits.The ideal candidate will have their bachelor's degree and 2 years of audit and/or fraud investigation experience.Interested? Apply today for immediate...
-
Programs Analyst
2 days ago
Honolulu, Hawaii, United States ALTRES Staffing Full timePrograms Analyst (medical A reputable health insurance company is seeking a Program Analyst to join their team and assist with Medicare and Medicaid related issues such as fraud, abuse, and audits.The ideal candidate will have their bachelor's degree and 2 years of audit and/or fraud investigation experience.Interested? Apply today for immediate...
-
Manager, Medicare Programs
3 weeks ago
Honolulu, United States HMSA Full timeLeadership Identify, initiate, and manage organization-wide projects to ensure that all HMSA's Medicare Program contractual obligations are met or exceeded. Manages necessary changes to existing systems, operations or workflows to address new/revised requirements of CMS/DHS/MQD. Structures work plans and project scope to deliver business impact on high...
-
Manager, Medicare Programs
4 weeks ago
Honolulu, United States HMSA Full timeLeadership Identify, initiate, and manage organization-wide projects to ensure that all HMSA's Medicare Program contractual obligations are met or exceeded. Manages necessary changes to existing systems, operations or workflows to address new/revised requirements of CMS/DHS/MQD. Structures work plans and project scope to deliver business impact on high...
-
Manager, Medicare Programs
2 days ago
Honolulu, United States HMSA Full timeLeadership Identify, initiate, and manage organization-wide projects to ensure that all HMSA's Medicare Program contractual obligations are met or exceeded. Manages necessary changes to existing systems, operations or workflows to address new/revised requirements of CMS/DHS/MQD. Structures work plans and project scope to deliver business impact on high...
-
Programs Analyst
1 week ago
Honolulu, United States ALTRES Staffing Full timePrograms Analyst (medical) (215137-14)A reputable health insurance company is seeking a Program Analyst to join their team and assist with Medicare and Medicaid related issues such as fraud, abuse, and audits. The ideal candidate will have their bachelor's degree and 2 years of audit and/or fraud investigation experience. Interested? Apply today for...
-
Programs Analyst
2 days ago
Honolulu, United States ALTRES Staffing Full timePrograms Analyst (medical) (215137-14)A reputable health insurance company is seeking a Program Analyst to join their team and assist with Medicare and Medicaid related issues such as fraud, abuse, and audits. The ideal candidate will have their bachelor's degree and 2 years of audit and/or fraud investigation experience. Interested? Apply today for...
-
Manager, Medicare Risk Adjustment
2 months ago
Honolulu, United States HMSA Full timeJob Summary **Hybrid Work Environment - Must reside in Hawaii ** The Manager, Medicare Risk Adjustment has organization level responsibilities for the administration of all provisions/requirements of HMSA's Medicare Risk Adjustment program. They are responsible for managing the development and implementation of successful activities that improve the...
-
Manager, Medicare Risk Adjustment
2 days ago
Honolulu, United States HMSA Full timeJob Summary **Hybrid Work Environment - Must reside in Hawaii ** The Manager, Medicare Risk Adjustment has organization level responsibilities for the administration of all provisions/requirements of HMSA's Medicare Risk Adjustment program. They are responsible for managing the development and implementation of successful activities that improve the...
-
Government Programs Analyst
2 weeks ago
Honolulu, United States Hawaii Dental Service Full timePOSITION SUMMARY The Government Programs Analyst is responsible for assisting the Director of Government Programs and Government Programs Administrator with Medicare and Medicaid markets with primary focus on fraud and abuse related reviews, audits, and special projects as needed. ESSENTIAL DUTIES AND RESPONSIBILITIES Key Responsibilities * Fraud and Abuse...
-
Business Analyst
5 days ago
Honolulu, United States Highgate Full timeYearly Highgate is a premier real estate investment and hospitality management company widely recognized as an innovator in the industry. Highgate is the dominant player in U.S. gateway markets including New York, Boston, Miami, San Francisco and Honolulu, with a rapidly expanding presence in Europe, Latin America, and the Caribbean. Highgate’s portfolio...
-
Business Analyst
1 month ago
Honolulu, United States Hawaii Growth - Honolulu Full timeCompensation Type: Yearly Highgate Hotels: Highgate is a premier real estate investment and hospitality management company widely recognized as an innovator in the industry. Highgate is the dominant player in U.S. gateway markets including New York, Boston, Miami, San Francisco and Honolulu, with a rapidly expanding presence in Europe, Latin America, and the...
-
Business Analyst
1 week ago
Honolulu, United States Hawaii Growth - Honolulu Full timeCompensation Type: Yearly Highgate Hotels: Highgate is a premier real estate investment and hospitality management company widely recognized as an innovator in the industry. Highgate is the dominant player in U.S. gateway markets including New York, Boston, Miami, San Francisco and Honolulu, with a rapidly expanding presence in Europe, Latin America, and the...
-
Business Analyst
1 month ago
Honolulu, United States Highgate Full timeCompensation Type Yearly Highgate Hotels Highgate is a premier real estate investment and hospitality management company widely recognized as an innovator in the industry. Highgate is the dominant player in U.S. gateway markets including New York, Boston, Miami, San Francisco and Honolulu, with a rapidly expanding presence in Europe, Latin America, and the...
-
Business Analyst
1 week ago
Honolulu, United States 'Alohilani Resort Waikiki Beach Full timeCompensation Type:Yearly Highgate Hotels: Highgate is a premier real estate investment and hospitality management company widely recognized as an innovator in the industry. Highgate is the dominant player in U.S. gateway markets including New York, Boston, Miami, San Francisco and Honolulu, with a rapidly expanding presence in Europe, Latin America, and the...
-
Junior IT Business Analyst
1 day ago
Honolulu, United States Hawaii Gas Full timeOverview: The Junior IT Business Analyst will collaborate with clients, advocating for information technology needs and assisting them in improving their business and technical processes. The Junior IT Business Analyst will partner with clients to perform feasibility studies and lead IT projects, raising clients' awareness of emerging IT capabilities and...