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

Engagement, Assessment and Planning Engages members in the case management program (outreach and successful enrollment) using diagnostic cost group classifications or other tools which identify the relative risk score and illness burden. Identifying catastrophic health care users with significant health care costs is a priority. Conducts and documents a comprehensive asse

Lead the oversight and monitoring of the medical cost trend improvement efforts, by driving cross functional teamwork efforts to identify, design, implement, and monitor initiatives that moderate the Organization's healthcare cost trends Lead and manage a portfolio of activities with a sharp focus on enhancing healthcare cost outcomes through diversified mitigation strate

Responsibilities include, but are not limited to the following Leads and manages the Identity Access Management team. Acts as a point of escalation for any user or business stakeholder issues. Establishes and maintains relationships with business units throughout the organization so as to understand their working environments and communications needs. Recommends and overs

Responsibilities include, but are not limited to the following Influence information strategy By partnering with business unit leadership, and through the rationalization of the information value chain, the information architect will provide strategic recommendations to maximize the value of information assets via their creation, access and use. Promotes the business valu

Prepare administrative work for the Health Coordinators to include but not limited to preparing HFA's, inputting 1147's, completing the call cadence to enroll members in the program, utilizing HMSA tools to identifying any gaps in care. Ensuring that services are initiated timely to include but not limited to assisting the Health Coordinator in monitoring service plan goa

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 for issues that are brought to the attention of the unit. Create and update o

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 for issues that are brought to the attention of the unit. Create and update o

Monitor, track and analyze legislation introduced at the state level. Generate weekly Executive Summary Report of key legislation. Develop and distribute weekly updates to HMSA executive staff throughout the legislative session. Monitor legislative hearings and meetings as needed. Conduct legislative research and compile summary reports on state and national health care i

Assist customers in a timely and accurate manner in phone interactions. Maintain quantity, timeliness, accuracy, and quality performance within established standards that support HMSA's ability to comply with customer performance requirements, while receiving and responding to inquiries. Conduct research for routine inquiries. Apply basic analytical and problem solving sk

Creates original content that engages our target audience and supports HMSA's business goals and objectives Researches, produces, writes, shoots, and edits in house videos and livestreams. Writes clear and compelling stories in HMSA's brand voice. Writes effective digital headlines and summaries that help attract audiences. Creates engaging social media posts that attract

Establishes relationships with business partners and the IT organization in order to provide technical solutions to meet user needs and influence strategic initiatives. Responsible for leading the analysis of IT requirements, alignment of IT resources and processes in order to meet the clients' organizational needs, as well as the design of enterprise solutions. Responsib

Develop and maintain processes and reports for internal and external performance monitoring of all provider database and credentialing activities to ensure compliance with corporate performance and/or regulatory guidelines. Understanding of healthcare laws and regulations, program guidelines and HMSA contractual obligations that affect Provider Operations' business areas.

Quality Improvement Interventions Analysis and Development Work as part of a quality team to continuously identify, plan, develop, implement, and evaluate interventions. Develop reports, analyses, and data mining to support program planning and interventions. Complete program and initiative evaluations such as return on investment and health outcomes Apply detailed analys

Quality Improvement Interventions Analysis and Development Work as part of a quality team to continuously identify, plan, develop, implement, and evaluate interventions. Complete program and initiative evaluations such as return on investment and health outcomes Gather and synthesize research studies, industry information, and BCBSA resources to gain insight and apply bes