Hawaii Medical Service Association
Utilization Management Business Analyst Job at Hawaii Medical Service Associatio
Hawaii Medical Service Association, Honolulu, HI, United States
- Utilize project management techniques to coordinate focused medical review projects as assigned. Conduct analysis to understand utilization trends. Document and present relative data and recommendations to management and/or oversight committees. Collaborate to implement strategies to improve quality outcomes and control healthcare cost trend in alignment with corporate initiatives.
- Collaborate with reporting SMEs to create reports or dashboards to reflect impact of UM programs as demonstrated by direct cost savings and/or changes in provider behavior. Create and maintain requirements documents for each report or dashboard.
- Identify, research, and resolve issues by making sound decisions in accordance with policies and procedures. Respond to telephone and written inquiries from providers and internal customers. Act as a liaison between Medical Management and internal departments. Build professional relations with various stakeholders
- Create and maintain policy, procedure, and desktop instruction documentation. Assist with education and training to HMSA staff and providers regarding Medical Management activities/projects and seek input and cooperation for the development of new programs.
- Support and participate in department and corporate workgroups and projects, as assigned.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
- Bachelor's degree and three years of prior work experience in related health care or insurance industry; or combination of education and work experience.
- Effective written and verbal communication skills.
- Project management skills.
- Knowledge of Project Management methods and utilization management concepts.
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.