Business Analyst II

6 days ago

Honolulu, United States Hawaii Medical Service Association Full time $59,000 - $116,000
**Hybrid Work Environment - Must reside in Hawaii**

Pay Range: $59,000 - $116,000

Note: Individuals typically begin between the minimum to middle of the pay range

Responsible to support the development and implementation of required activities to ensure compliance with Centers for Medicare and Medicaid Services (CMS) requirements and mandates, that ensures compliance with Medicare contracting and reporting requirements.

Coordinate operational activities with appropriate department personnel, establish work plans, target dates, conduct regular status meetings, report status, identify and escalate issues, recommend solutions, track, and report to resolution. Develop and prepare HMSA's corrective action plans in response to audit or monitoring findings to meet performance standards. Serve as the department's representative/liaison on organizational projects/workgroups.
Minimum Qualifications
  • Bachelor's degree and three years of related work experience; or equivalent combination of education and related work experience.
  • Effective oral and written communication skills.
  • Strong analytical and interpretive skills.
  • Effective analytical and interpretive skills.
  • Intermediate working knowledge of Microsoft Office Word and Excel.
  • Basic working knowledge of Microsoft Outlook and PowerPoint.

Duties and Responsibilities
  • Support the administration and management of the day to day operational activities needed to comply with CMS requirements and HMSA standards. Be knowledgeable on all CMS regulations and HMSA operational standards. This duty requires the analyst to:
    • Ensure all HMSA's Medicare Program contractual obligations and requirements are met or exceeded in appropriate operational depts. Interpret CMS regulations and provide operational impact guidance to departments and HMSA's contracted vendors. Adjust existing systems, operations, and/or workflows to adapt to the ever-changing requirements of CMS and any identified deficiencies in current program quality and administration. Then monitor compliance via report and data validation.
    • Monitor communications from CMS and determine if/how changes to operations are needed in applicable internal departments. Follow-up to ensure correct action was taken on a timely basis.
    • Handle ad hoc questions, research issues, and provide assistance to departments to assess impact and determine best course of action.
  • Complete administrative reports based on business needs, program compliance, plan performance, and as assigned. Advise the manager on significant matters pertaining to regulatory and reporting requirements, program compliance, or needed program changes.
  • Resolve all member cases and ensure CMS timeliness and accuracy requirements are met. Conduct quality assurance and process improvement reviews to assess compliance and verify appropriate actions are taken. Monitor and track HMSA's compliance with CMS program standards, policies, and guidance through multiple sources, such as HMSA submitted reports to CMS, CMS generated performance metrics, and department self-reported issues.
  • Coordinate, develop and help implement Medicare Program policies and procedures to operationalize CMS requirements affecting multiple departments. Maintain understanding of Medicare program operations as it relates to marketing, membership enrollment, claims processing, financial statements, customer service, provider contracting, quality improvement, utilization management, etc.
  • Obtain policy clarifications/additional guidance, coordinate special administrative and operational requests, respond to CMS inquiries and requests for information, and coordinate CMS performance reviews. Participate in the development and implementation of required corrective action plans to address CMS audit and internal quality assurance review findings. Coordinate and monitor activities with appropriate department staff to ensure that corrective action plans are implemented timely and accurately.
Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid

  • Program Budget Analyst II Position in Hawaii

    3 weeks ago

    Honolulu, Hawaii, United States Hawaii DOT Full time

    Job Title:Program Budget Analyst IIAbout the Job:We are seeking a highly skilled Program Budget Analyst II to join our team at the Hawaii DOT. This is a unique opportunity to utilize your analytical skills and experience in program analysis and budgeting to make a meaningful impact on our organization.Key Responsibilities:Analyze and evaluate program data to...

  • Business Operations Analyst

    2 days ago

    Honolulu, Hawaii, United States HMSA Full time

    About the RoleWe are seeking an experienced Senior Business Analyst to join our team at HMSA. In this role, you will be responsible for providing leadership and guidance to other analysts, managing projects related to developing and improving our Medicare line of business, and collaborating closely with other teams and external partners.

  • Business Analyst

    3 months ago

    Honolulu, United States TEKsystems Full time

    Job DescriptionJob Description6 month contract to hireSummary of Job Duties: - Develop and author procedures and workflows for Business Analysis group to standardize and document requirements processes- Work closely with business stakeholders to observe, elicit and define business requirements to support changes to process, procedures and use of software...

  • Senior Business Process Analyst

    2 weeks ago

    Honolulu, Hawaii, United States TEKsystems Full time

    Job DescriptionWe are seeking a highly skilled Business Analyst to join our team at TEKsystems.Key Responsibilities:Develop and author procedures and workflows for Business Analysis to standardize and document requirements processes.Work closely with business stakeholders to observe, elicit and define business requirements to support changes to processes,...

  • Business Analyst II

    3 weeks ago

    Honolulu, United States HMSA Full time

    Support the administration and management of the day to day operational activities needed to comply with CMS requirements and HMSA standards. Be knowledgeable on all CMS regulations and HMSA operational standards. This duty requires the analyst to: Ensure all HMSA's Medicare Program contractual obligations and requirements are met or exceeded in appropriate...

  • Business Analyst, Mid

    2 weeks ago

    Honolulu, United States Booz Allen Hamilton Full time

    Job Number: R0209466Business Analyst, Mid The Opportunity: You know that true progress is made at the intersection of business and tech, and as an IT Business Analyst, you can develop your skills in both. Here, you'll have the chance to work with an Agile team as they develop digital products to support your clients' most pressing missions. We're looking for...

  • Business Intelligence Analyst

    2 weeks ago

    Honolulu, Hawaii, United States Cayuse Holdings Full time

    About Cayuse HoldingsCayuse Federal Services, a subsidiary of Cayuse Holdings, provides cutting-edge solutions to federal government clients, focusing on cost-effective excellence. Our capabilities, market-relevant service offerings, past performance credentials, and diverse status enable government clients to engage quickly and confidently with us. Core...

  • Senior Business Analyst | Project Manager

    2 weeks ago

    Honolulu, Hawaii, United States HMSA Full time

    About the RoleWe are seeking a highly skilled Senior Business Analyst | Project Manager to join our team at HMSA. As a key member of our organization, you will play a crucial role in driving business solutions and project success.

  • Business Analyst

    7 days ago

    Honolulu, United States HMSA Full time

    Support the administration and management of the day to day operational activities needed to comply with CMS requirements and HMSA standards. Be knowledgeable on all CMS regulations and HMSA operational standards. This duty requires the analyst to:Ensure all HMSA‘s Medicare Program contractual obligations and requirements are met or exceeded in appropriate...

  • Senior Business Intelligence Analyst

    2 weeks ago

    Honolulu, Hawaii, United States Bishop & Company Full time

    Bishop & Company is seeking a skilled Senior Business Intelligence Analyst to join their data team in Honolulu, HI.Job SummaryWe are looking for an experienced analyst to help us drive business decisions with data-driven insights. As a Senior Business Intelligence Analyst, you will be responsible for analyzing complex data sets, developing reports, and...

  • Business Analyst

    3 weeks ago

    Honolulu County, United States Booz Allen Hamilton Full time

    Job Number: R0209466Business Analyst, MidThe Opportunity:You know that true progress is made at the intersection of business and tech, and as an IT Business Analyst, you can develop your skills in both. Here, you‘ll have the chance to work with an Agile team as they develop digital products to support your clients‘ most pressing missions. We‘re looking...

  • Strategic Business Solutions Analyst

    2 weeks ago

    Honolulu, Hawaii, United States Hawaii Medical Service Association Full time

    Job Overview:Hawaii Medical Service Association is seeking a highly skilled Strategic Business Solutions Analyst to join our team. As a key member of our organization, you will play a critical role in implementing solutions that meet business needs and ensuring requirements are met through testing and monitoring.Key Responsibilities:We are looking for a...

  • Analyst

    7 days ago

    Honolulu, United States HMSA Full time

    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 &...

  • Business Analyst

    2 weeks ago

    Honolulu, HI, United States Cymertek Corporation Full time

    Business Analyst (IT) KEY SUMMARY We are seeking a proactive and analytical Business Analyst (IT) to bridge the gap between technology and business objectives. In this role, you will work closely with stakeholders to gather, document, and translate business requirements into actionable technical solutions. Your expertise in analyzing processes and...

  • Business Analyst Intern

    3 weeks ago

    Honolulu, Hawaii, United States KMH LLP Full time

    We are seeking a talented Business Analyst Intern to join our Solutions division at KMH LLP. The ideal candidate will have strong work ethic, excellent teamwork skills, and a desire to learn and grow as a professional.Key ResponsibilitiesAssist in the completion of client service work by performing assigned tasks in technical areas.Contribute to engagement...

  • Cybersecurity Analyst

    2 months ago

    honolulu, United States Tyto Athene, LLC Full time

    Tyto Athene is searching for a Cybersecurity Analyst located at Ford Island in Honolulu, Hawaii to support GSM-O II Network Assurance in providing for the integrity and security of cyber systems and networks for the Defense Information Systems Agency’s (DISA) global Information Technology enterprise. Responsibilities:Monitors systems and networks for...

  • Cybersecurity Analyst

    7 months ago

    Honolulu, United States Tyto Athene, LLC Full time

    Tyto Athene is searching for a Cybersecurity Analyst located at Ford Island in Honolulu, Hawaii to support GSM-O II Network Assurance in providing for the integrity and security of cyber systems and networks for the Defense Information Systems Agency’s (DISA) global Information Technology enterprise. Responsibilities:Monitors systems and networks for...

  • System Analyst

    6 days ago

    Honolulu, United States HMSA Full time

    Responsible for analysis, design, development, integration, maintenance and support of applications. Responsibilities include, but may not be limited to, the following:Leads and/or participates in the project planning process with clients, business analysts and team members.Assists in the development of work plan timelines. May manage workflows to meet...

  • System Analyst

    3 weeks ago

    Honolulu, United States HMSA Full time

    Responsible for analysis, design, development, integration, maintenance and support of applications. Responsibilities include, but may not be limited to, the following:Leads and/or participates in the project planning process with clients, business analysts and team members.Assists in the development of work plan timelines. May manage workflows to meet...

  • Business Analyst

    1 month ago

    Honolulu, Hawaii, United States Hawaiian Electric Full time

    Job Summary:We are seeking a highly skilled Business Analyst to join our team at Hawaiian Electric. The ideal candidate will have experience in billing and rate design, as well as strong analytical and problem-solving skills.Key Responsibilities:Coordinate and monitor utility and non-utility billing functions, ensuring policies are in accordance with the...