Manages community health by establishing and maintaining trusting relationships with individuals, families, and providers to promote health, recovery, resiliency, and wellness. Advocating in members and families' best interests to ensure needs/choices are accurately represented/supported, and that timely care/services are delivered. Performs screenings/assessments regardi

Quality Improvement Operations Provide direction and manage HMSA's overarching Quality Improvement program, including the oversight of staff and necessary resources required to design and implement programs related to compliance with accreditation, regulatory and program requirements (e.g., NCQA, Med QUEST, CMS, OPM, etc.). Oversee project teams and provide guidance to su

a. Helps to lead and contributes to strategic design, implementation, and management of strategy roadmaps, strategic frameworks, and initiatives. Works with key stakeholders to strategically design and implement strategy initiatives with guidance from executive sponsors, subject matter experts, and other staff as needed Utilizes systems thinking to ensure strategies are d

a. Project management and facilitation Develops and maintains project plans, timelines, and scope documents for strategy initiatives. Proactively manages deliverables, timelines, and budget Monitors and takes appropriate action to ensure various task and system related deliverables are accomplished in an accurate and timely manner. Develops strategies and tactics based on

Prioritizes approved invoices and check requests according to payment terms. Familiarizes with company policies and navigating steps in Dynamics GP, Certify and CentreSuite. Verifies approver's level of authority to ensure that the cost center and the amount being charged are authorized. Follows through with requestor and obtains appropriate approval as needed. Validates

Resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by Researching and collaborating with other units or departments to find a solution Accurately updating member records Contacting external partners who provide services for/to HMSA's

Execute, monitor, and lead implementation of payment integrity strategy. Assess the success of payment integrity activities for continued alignment with organizational goals (e.g., Healthcare Cost Trend) and ensure expected results are being achieved. Communicating external teams' outcomes, data analysis, complex processes and action plans to internal teams. Provides vend

Performance Proactively service and grow HMSA products and services through various methods including site visits, on line meetings, telephone and email correspondence, power point presentations, and one on one customer servicing. Protect HMSA's market share through the successful renewal and retention of assigned accounts by strategically aligning HMSA's value propositio

Support the development of new products and benefits by performing the analysis and coordinating the efforts of others to produce the necessary information to be used in decision making by HMSA leadership. Produce comprehensive assessments of proposed changes through collaborative efforts with internal partners and subject matter experts. Prepare financial, brand, regulat

Stakeholder Management Build strong relationships with stakeholders at all levels, understanding their needs, and ensuring clear communication throughout the product development lifecycle. Understand stakeholders' vision, goals, mission, gaps, and opportunities and deliver technical products that are aligned with stakeholders' needs. Level set stakeholders' expectations a

Stakeholder Management Build strong relationships with stakeholders at all levels, understanding their needs, and ensuring clear communication throughout the product development lifecycle. Understand stakeholders' vision, goals, mission, gaps, and opportunities and deliver technical products that are aligned with stakeholders' needs. Level set stakeholders' expectations a

Maintain thorough knowledge of HMSA's provider network and the business with focus on provider contracts and reimbursement methodologies while working collaboratively across departments and our vendor partners to identify, document and maintain business requirements necessary for successful implementation. Researches the current state of HMSA's systems to include QNXT & C

Performance Manage Union Pod to stated performance metrics and goals. Create a performance oriented culture. Develop and implement account plans to leverage employer groups' objectives and how HMSA products fit into their benefit program. Use exceptional selling skills to promote and implement products and services through various methods, including site visits, correspon

Coordinate and deliver training programs using an appropriate mode (in person or virtual) to provide understanding of department technology and workflows, relevant laws, and HMSA plans and benefits. Manage logistics of training including planning, scheduling, and preparation of necessary tools and materials. Assist the department with daily business operations and functio

Assist the Director to implement Credit Union policies, procedures and practices which include the organization's financial goals, objectives, and budgets. Make business improvement recommendations and coordinate with the Director to seek approval from the Board of Directors. Facilitate, organize, and plan all board meetings, credit union annual dinners and annual busines