Plan Performance Analyst III

5 days ago


Honolulu, Hawaii, United States HMSA Full time
Job Summary

We are seeking a highly skilled Operational Quality Assurance Specialist to join our team at HMSA. As a key member of our quality assurance team, you will be responsible for ensuring the accuracy and integrity of our operational quality measures.

Key Responsibilities
  • Audit and review operational quality measures for All Private Business and/or FEP lines of Business, identifying errors and documenting them without assistance.
  • Assist other staff in resolving audit issues, noting the probable cause or causes, impact to HMSA (if applicable), and recommendations for correction.
  • Apply detailed knowledge of HMSA's benefits and their application, as well as proficient knowledge of HMSA's Claims, Customer Service, and Enrollment Systems.
  • Lead meetings with staff/management in multiple departments to resolve issues raised during the review.
  • Research and explain exceptions to appropriate management for correction and document management responses.
  • Assist in coordinating monthly/quarterly reporting of results of reviews for reporting to executive staff.
  • Provide training and perform QA reviews as assigned.
  • Analyze changes in HMSA Products & Business, as well as changes in Quality measures such as the BCBSA guidelines.
  • Perform other miscellaneous quality assurance reviews, including assisting external clients/auditors in verifying the accuracy of group data.
Requirements
  • Proficient ability to apply HMSA's medical policies in equating diagnosis to procedures listed on claims.
  • Ability to perform database queries to gather summary information and make conclusions based on it.
  • Strong analytical and problem-solving skills, with the ability to lead meetings and communicate effectively with staff/management.


  • Honolulu, Hawaii, United States Central Pacific Bank Full time

    Position Overview: Credit Risk Analyst I-III: The Credit Risk Analyst I-III plays a crucial role in evaluating risk and analyzing Private Banking credit applications to streamline the credit decision-making process. This position involves collaboration with Private Banking Officers and/or Credit Administrators, as well as direct engagement with clients and...


  • Honolulu, Hawaii, United States HMSA Full time

    Job SummaryAs a Senior Financial Healthcare Data Analyst III at HMSA, you will lead provider negotiations and projects that include the Clinical Integration Division, Health Management Operations, Finance Division, and Executive Leadership. Your comprehensive statistical analysis will support corporate strategies and initiatives for all Lines of Business.Key...


  • Honolulu, Hawaii, United States HMSA Full time

    Operational Quality Specialist **Job Summary** We are seeking a highly detail-oriented Operational Quality Specialist to assist with and/or perform operational quality measures for limited lines of business. The successful candidate will be responsible for reviewing provider contracts and rates, comparing them to plan benefits, and ensuring HMSA's payment...


  • Honolulu, Hawaii, United States Dice Full time

    Position Overview:We are seeking a skilled Financial Analyst to support the intricate budgeting needs within the Information Technology sector of our organization.The successful candidate will possess strong communication abilities, as they will be responsible for conveying budgeting requirements to management and leading monthly discussions.Experience with...


  • Honolulu, Hawaii, United States ZipRecruiter Full time

    Position Overview:A prominent organization is in search of a Senior Financial Planning Analyst to enhance their Financial Planning & Analysis (FP&A) team. This role is pivotal in developing financial models, conducting data assessments, and performing forecasts to bolster business strategies.Key Responsibilities:1. Formulate and oversee financial planning...


  • Honolulu, Hawaii, United States ZipRecruiter Full time

    Position Overview:ZipRecruiter is in search of a Senior Financial Planning Analyst to enhance our financial planning and analysis team.In this pivotal role, you will engage in financial modeling, data interpretation, and forecasting to bolster business strategies. Collaborate with various departments to deliver insightful analyses that inform strategic...


  • Honolulu, Hawaii, United States HMSA Full time

    Job SummaryAs a Senior Financial Healthcare Data Analyst III at HMSA, you will lead provider negotiations and projects that drive business growth and improvement. You will analyze complex data from multiple sources to inform corporate strategies and initiatives, ensuring alignment with business objectives.Key ResponsibilitiesDevelop and implement data-driven...


  • Honolulu, Hawaii, United States Dice Full time

    Position Overview:We are seeking a skilled Financial Analyst to support a prominent healthcare organization in navigating complex budgeting processes within the Information Technology sector.Key Responsibilities:Collect and analyze various IT processes and requirements to prepare insightful recommendations for budget management.Execute financial management...


  • Honolulu, Hawaii, United States ZipRecruiter Full time

    Job Overview:Bishop & Co. is in search of a Senior Financial Planning Analyst to contribute to the FP&A division of our esteemed client.In this capacity, you will play a pivotal role in financial modeling, data interpretation, and forecasting to bolster business strategies. You will collaborate with various departments to deliver actionable insights that...


  • Honolulu, Hawaii, United States Bishop & Company, Inc. Full time

    Bishop & Company, Inc. is looking for a Lead Financial Planning Analyst to become an integral part of our client's Financial Planning & Analysis (FP&A) team.In this position, you will play a crucial role in financial modeling, data interpretation, and forecasting to enhance business strategies. Work alongside various departments to deliver insightful...


  • Honolulu, Hawaii, United States Bishop & Company, Inc. Full time

    Job OverviewBishop & Company, Inc. is in search of a Lead Financial Planning Analyst to enhance our client's Financial Planning & Analysis (FP&A) team.In this pivotal role, you will be instrumental in crafting financial models, conducting data assessments, and projecting future financial scenarios to bolster business strategies. You will work alongside...


  • Honolulu, Hawaii, United States JMark Services Inc. Full time

    Job Title: Linguist and Cultural AnalystJMark Services Inc. is seeking a highly skilled Linguist and Cultural Analyst to support our intelligence operations. As a key member of our team, you will be responsible for providing language-related analytical services, including translation, transcription, interpretation, and monitoring capabilities.Key...


  • Honolulu, Hawaii, United States JMark Services Inc. Full time

    Job Title: Linguist and Cultural AnalystJMark Services Inc. is seeking a highly skilled Linguist and Cultural Analyst to support our intelligence operations. As a key member of our team, you will be responsible for providing language-related analytical services, including translation, transcription, interpretation, and monitoring capabilities.Key...


  • Honolulu, Hawaii, United States Booz Allen Hamilton Full time

    The Opportunity:As a seasoned professional in defense operations, your distinct experience encourages you to envision broader possibilities, strive for excellence, and inquire where others may hesitate. Your deep industry expertise and advisory capabilities are essential in addressing some of our clients' most intricate challenges, delivering solutions that...


  • Honolulu, Hawaii, United States JMark Services Inc. Full time

    About the RoleJMark Services Inc. is seeking a highly skilled Linguist and Cultural Analyst to join our team. As a successful small business, we recognize that our employees are our most valuable resource. We offer a comprehensive benefits package and support for the success and welfare of each employee.Job SummaryThis is a full-time position that requires a...


  • Honolulu, Hawaii, United States SSFM Full time

    Job Title: Urban and Regional Planner at SSFMPlanner III (3+ years experience)Overview:SSFM is seeking a dedicated Urban and Regional Planner to enhance our innovative team. The successful candidate will play a key role in the planning, design, and management of diverse projects under the guidance of the Planning Group Manager.Key Responsibilities:Contribute...


  • Honolulu, Hawaii, United States SSFM Full time

    Job Title: Urban and Regional Planner at SSFMPlanner III (3+ years experience)Overview:SSFM is seeking a dedicated Urban and Regional Planner to enhance our innovative team. The successful candidate will play a crucial role in strategizing, designing, and overseeing a variety of projects under the guidance of the Planning Group Manager.Key...


  • Honolulu, Hawaii, United States Hawaii DOT Full time

    Job SummaryWe are seeking a highly skilled Program Budget Analyst V to join our team at the Hawaii DOT. As a key member of our financial planning team, you will be responsible for reviewing and analyzing complex financial data to inform strategic business decisions.Key ResponsibilitiesDevelop and implement financial plans and budgets for major...


  • Honolulu, Hawaii, United States HMSA Full time

    Job SummaryAs a Senior Financial Healthcare Data Analyst III at HMSA, you will lead provider negotiations and projects that include the Clinical Integration Division, Health Management Operations, Finance Division, and Executive Leadership. Your comprehensive statistical analysis will support corporate strategies and initiatives for all Lines of Business.Key...


  • Honolulu, Hawaii, United States Hawaii State Department of Education Full time

    Job SummaryWe are seeking a highly skilled Data Processing Systems Analyst to join our team at the Hawaii State Department of Education. As a key member of our team, you will be responsible for analyzing and designing systems for electronic data processing, as well as participating in systems analysis and development.Key ResponsibilitiesConduct fact-finding...