Hmsa Honolulu , HI 96812
Posted 4 days ago
Full-timeNon-exempt
Pay Range: $42,000 - $78,000
Note: Individuals typically begin between the minimum to middle of the pay range
Responsible for coordinating and performing activities related to the provider onboarding process, provider education, provider outreach and issue resolution. Communicates with external and internal customers and manages work within HMSA systems including eVIPS and Salesforce.
Associate's degree and two years of related work experience; or an equivalent combination of education and related work experience.
Excellent verbal and written communication skills
Excellent time management, organizational, and prioritization skills
Intermediate knowledge of Microsoft Office applications. Including but not limited to Word, Excel, PowerPoint, and Outlook.
Communicates directly with external partners and providers via phone, email or written correspondence in a professional, knowledgeable and timely manner to provide education; to obtain required documentation and/or clarification; and to provide direction in support of onboarding or provider claims inquiries.
Coordinates with internal business for resolution of provider inquiries/issues related to onboarding into HMSA's provider network, claims processing and benefits.
Provides first-level contact for internal business areas to ensure that requests for field outreach are complete, actionable and if not, redirect accordingly. Monitors and analyzes case trends to proactively identify opportunities for improvement and/or development.
Maintain and manage the Field unit's outreach/planning calendar and project list to ensure compliance with all deadlines related to CMS, HEDIS, STARs etc. Actively work with management to develop additional workflows and reporting capabilities for Field outreach/project metrics.
Innovation, process improvement activities
Perform all other miscellaneous responsibilities and duties as assigned or directed.
Hmsa