hmsacareers

Assessment & Planning Conducts comprehensive assessments--including physical, psychosocial, and health literacy evaluations--and interprets relevant diagnostic data to identify member and family needs. Applies critical thinking skills to analyze complex cases and determine underlying causes contribu

CUSTOMER EXPERIENCE Provide all customers with an exceptional customer-focused and positive HMSA Center experience. Ensure that the experience meets the customer's needs and exceeds their expectations. Communicate and promote HMSA's brand message and commitment to service excellence. Build enduring

CUSTOMER EXPERIENCE Provide all customers with an exceptional customer-focused and positive HMSA Center experience. Ensure that the experience meets the customer's needs and exceeds their expectations. Communicate and promote HMSA's brand message and commitment to service excellence. Build enduring

Responsibilities include, but are not limited to the following: Leads and manages the Enterprise Application Administration team. Serve as technology lead and liaison to HMSA in developing and linking solutions to company requirements, goals, and objectives to create and maintain a competitive advan

Data Management: Reviews data sources and preps needed data. Identifies and communicates issues, limitations, and risks with data sets/reports. Identifies existing and new data sources. Performs data prototyping, if necessary, to agree what data can/not be used. Preps data for use in analysis, goes

Data Management: Reviews data sources and preps needed data. Identifies existing and new data sources. Performs data prototyping, if necessary, to agree what data can/not be used. Preps data for use in analysis, goes back to source if problems are found, and identifies other options/alternatives if

Performance Use account data and critical thinking to effectively marry customer goals and objectives to HMSA's products and services. Achieve membership goals, quotas and minimum activity standards Manage RFI and RFP responses ensuring accuracy and timeliness Promote HMSA's products and services th

Act as a point-of-contact and subject matter expert. Communicate with vendor and internal stakeholders to quickly and accurately obtain or provide information regarding enrollment related inquiries accurately, professionally, and timely. Remain apprised of electronic enrollment processes, transactio

Data Analysis and Reporting Conduct high quality, objective analysis to support performance optimization and strategic initiatives. Collect, interpret, and evaluate Key Performance Indicators (KPIs) and related information to identify trends, issues, root causes, and potential problems while proacti

Develop and execute the organization's AI and automation strategy in alignment with overall business goals. Oversee the end-to-end lifecycle of AI projects, from ideation and prototyping to deployment and maintenance. Lead and mentor a team of AI and automation specialists, data scientists, engineer

Manage community health by establishing and maintaining trusting relationships with individuals, families, and providers to promote health, recovery, resiliency, and wellness. Advocate and support members and their families by prioritizing their needs and preferences, making sure they receive approp

Provides general production support: Monitor daily production performance and inventory levels as assigned. Conduct data and trend analysis to identify areas of improvements. Triage daily production issues. Recommend and implement interim workarounds. Recommend solutions and/or corrective actions fo

Plan Document Fabrication and Amendments Research, write and facilitate the production of HMSA Plan Documents (Guide to Benefits, Certificates, Federal Plan Brochure, Summary of Changes and Self-Insured Administrative Services Agreements) with Product management (PM) and Account Management and Sales

Responsible for leading the support of HMSA's storage infrastructure. Responsibilities include, but are not limited to the following: Ensures the reliability of HMSA's storage infrastructure, to include the planning and implementation of enhancements. Develops Reference Architectures and technology

Program Management:Manages multiple high-level, mission-critical, cross-departmental programs and project(s), from design through implementation, with guidance from executive sponsors: Facilitates the definition of project scope, goals, and deliverables and lead the implementation phase to ensure co

Monitor, evaluate, educate, and implement FEP program requirements related to Utilization Management (UM), Case Management (CM), Medical Management (MM), and Disease Management (DM) activities to areas within the department for appropriate action. This includes tracking daily operations to ensure de

Analyzes enterprise-wide financial performance to support strategic planning and decision-making processes Facilitates the development of sophisticated financial reporting frameworks that integrate multiple business segments Designs complex financial models that support long-term forecasting and sce

Reporting, Research & Analysis Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business with minimal guidance. Interprets financial and enrollment data from internal and external sources, identifying opportunities and problems compared

Reporting, Research & Analysis Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business using prescribed guidelines or policies. Gathers, validates, and interprets financial and enrollment data from internal and external sources. Suppor

Reporting, Research & Analysis Runs reports assisting analysis of premium revenue, risk adjustment payments, and other revenue streams related to lines of business. Gathers and validates financial and enrollment data from internal and external sources. Supports RAF and financial data needs of progra