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The Provider Operations Business Analyst will be responsible for performance monitoring, research, analysis, development, implementation and coordination of Provider Operation's initiatives and related projects to ensure the highest integrity of HMSA's Provider Network data, credentialing, directories, and related operational functions.
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Prepare case files for presentation to Provider Operations Leadership and Credentialing Committee in order to satisfactorily meet all standards as required by HMSA policies and procedures, State and Federal regulatory requirements and all relevant accreditation standards pertaining to the credentialing for HMSA providers in all lines of business including commercial, Medicare, Medicaid and ACA products.
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This position is considered the local Devoted Health leader and directly interfaces with provider and business partners with support from the Regional President and corporate leadership and functional areas.
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Manage and direct ongoing assessment of business functions for numerous departments within the scope of NCQA standards (e.g., Provider Services, Utilization Management, Medical Management, Integrated Health Management Services, Customer Relations, etc.
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Job Title: Preschool Teachers and Caregivers for locations in Oahu & Maui. (Honolulu, Kaneohe, Kailua, and Pearl City on Oahu plus Kihei on Maui) About Us: At Kama’aina Kids, we're more than just a childcare provider or a daycare– we're a community that values our employees and is dedicated to serving children, families, and our communities.
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PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations. PharMerica is the long-term care pharmacy services provider of choice for senior living communities, skilled nursing facilities, public health organizations and post-acute care organizations.
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Abiomed, part of Johnson & Johnson MedTech, is a leading provider of medical devices that provide circulatory and respiratory support, with a mission of recovering hearts & saving lives. Abiomed, part of Johnson & Johnson's MedTech, is recruiting for a Senior Regulatory Affairs Specialist.
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Today, Zurich North America is a leading provider of commercial property-casualty insurance solutions and a wide range of risk management products and services for businesses and individuals. Juris Doctor and 2 or more years of experience in the Claims and/ or Litigation Management area.
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Serves as a liaison with the dental profession and represents the professional dental viewpoint; as a local provider liaison/advocate between HDS and MedQUEST. Represents HDS at dental consultant conferences and meetings.
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Coordinates patient and provider services (Specialty Pharmacy, Specialty Distributor, Patient Services) to assure complete patient care (diagnosis through completion of treatment). Minimum 4 years of demonstrated success in a hospital/institutional or specialty pharmaceutical sales position or 4 years clinical experience such as an Advanced Registered Nurse Practitioner, Physician Assistant, Registered Nurse, Physical Therapist and/or Social Worker.
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Advanced Practice Provider - Psychiatry Nocturnist. An Advanced Practice Provider (APP) is a medical provider who treats, diagnoses, prescribes, and/or performs or assists in surgical procedures.
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Understands Cloud Concepts for GCP, AWS, Azure Cloud, as well as Cloud Service Provider (CSP) billing and cost structures. Skilled in the following tools: YAML, Helm, Ansible, IaC – Terraform Enterprise OpenShift.
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Oshkosh AeroTech is a leading provider of aviation ground support products, gate equipment and airport services to commercial airlines, airports, air-freight carriers, ground handling and military customers.
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Oversees new stock award delivery, tracking and vesting, including administration of on-line award acceptance, in close collaboration with the stock plan service provider (Morgan Stanley). Today, Xerox scientists and engineers are continuing our legacy of innovation with disruptive technologies in digital transformation, augmented reality, robotic process automation, additive manufacturing, Industrial Internet of Things and cleantech.
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Knowledge of utilization and/or claims cost management concepts, principles and practices (e.g., prior authorization, medical necessity, provider payment integrity, waste and abuse, etc.) The Utilization Management Strategy Lead role works closely with internal and external stakeholders, such as clinical operations, markets, provider contracting, analytics to identify opportunity areas, set priorities, design and execute initiatives, monitor results, and communicate findings and recommendations.
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childcare provider daycare jobs in Honolulu, HI
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