Jobs at HMSA

Leads financial system testing and Agile activities, troubleshoots system issues, validates HIPAA EDI and ERA transactions, reconciles accounts and claims payments, prepares journal entries and payment transactions, supports audits and financial reporting, researches regulatory requirements, and coordinates implementation with business and technical stakeholders.

Supports financial system implementations and testing, troubleshoots system issues, and bridges business and technical teams through Agile processes. Validates HIPAA EDI and ERA transactions, resolves payment discrepancies, performs account reconciliations, prepares journal entries and payment transactions, and supports financial reporting and audits. Researches regulatory requirements and coordinates compliance implementation with stakeholders. Provides guidance to junior staff and documents financial workflows and procedures.

Leads government accounting and financial reporting for Medicare, Medicaid, federal programs, and related business lines. Responsibilities include preparing accruals, maintaining ledgers, researching accounting issues, developing financial and operational reports, managing internal controls, analyzing reimbursement and contracting strategies, resolving data quality issues, and leading business and system projects. Presents findings and recommendations to management while ensuring accurate, timely, and audit-ready deliverables.

Manages strategic employer-group accounts, drives new sales, renewals, retention, and membership growth. Develops account plans, conducts prospecting and presentations, leads account service teams, negotiates healthcare benefit solutions, analyzes utilization and financial arrangements, and builds executive-level customer relationships. Maintains healthcare industry and competitive knowledge, manages sales pipelines, coordinates proposals, and reports sales activity. Requires Hawaii health and life insurance licensing, business travel, and strong communication and presentation skills.

Manages technical services teams across infrastructure, communications, security, systems, desktop, service desk, enterprise applications, or identity management. Oversees staffing, projects, vendors, budgets, service levels, incident and problem management, governance, root-cause analysis, and technical solution delivery. Develops team plans, mentors staff, manages performance, and ensures business technology needs are met within established standards and budgets.

Manages and prepares data from internal and external sources, validates data quality, performs descriptive, predictive, and prescriptive analysis, and documents methodologies and outcomes. Develops and maintains self-service reporting tools and dashboards, supports regular and ad hoc reporting, trains customers, and presents audience-appropriate findings. Identifies anomalies, investigates root causes, ensures reproducibility, and provides recommendations to support data-driven underwriting and actuarial decisions.

Manages and prepares data from internal and external sources, evaluates data quality, performs descriptive, predictive, and prescriptive analysis, and documents reproducible methodologies. Develops and enhances self-service reporting and analytics tools, gathers requirements, manages delivery milestones, trains customers, and presents findings to support data-driven decisions. Requires strong data interpretation, visualization, database, OLAP, and communication skills, with knowledge of SQL, R, SAS, or SPSS.

Manage national employer accounts, serving as the primary contact for account issues and customer relationships. Develop solutions aligned with client goals, manage RFI and RFP responses, support proposals, meet membership and activity targets, and educate employers on healthcare products, trends, regulations, and costs. Analyze customer needs, negotiate outcomes, track activities in Salesforce, monitor competition, and communicate account risks and sales intelligence to leadership.

Serves as a subject matter expert for electronic enrollment inquiries and transactions. Investigates and corrects processing errors, handles complex membership changes, identifies system and data-flow issues, manages problems through resolution, and recommends process improvements. Collaborates with vendors, employer groups, internal teams, and management offices while analyzing data, documenting root causes, developing workarounds, and training stakeholders on approved solutions.

Develops and executes the organization’s AI and automation strategy, overseeing projects from prototyping through deployment and maintenance. Leads and mentors AI specialists, data scientists, engineers, and analysts while collaborating with IT, product, operations, and compliance teams. Establishes AI development and governance practices, ensures regulatory and ethical compliance, manages budgets and resources, tracks project risks and outcomes, and reports to senior leadership. Promotes innovation and continuous professional development.

Provides production support by monitoring performance and inventory, analyzing trends, triaging issues, managing access requests, supporting audits, and updating workflows. Assists with testing, requirements-based test cases, production fixes, and project implementations. Develops training materials, conducts presentations, and supports operational documentation and process improvements.

Researches, writes, updates, and facilitates production of health plan documents and self-insured administrative services agreements. Analyzes benefit and language changes, ensures compliance with authorization and document-control procedures, maintains content repositories and tracking databases, supports audits, and contributes to document automation and redesign. Provides internal and external support regarding plan publications, historical benefit language, and administrative agreements while assisting with training and policy updates.

Leads storage infrastructure support, architecture, security, availability, backups, SAN/NAS operations, replication, disaster recovery, migrations, monitoring, troubleshooting, vendor coordination, and infrastructure upgrades. Develops standards, documentation, replacement plans, and service improvements while supporting highly secure datacenter environments. Provides technical consultation, project planning, incident escalation, user training, mentoring, and on-call support. Occasional overnight travel to remote Hawaiian Island locations may be required.

Manages multiple mission-critical, cross-functional programs from design through implementation. Develops project plans, timelines, budgets, and resource allocations; manages risks, issues, vendors, contracts, and stakeholder communications. Leads project teams, gathers and analyzes business requirements and trends, presents program insights, coordinates governance activities, and aligns departmental initiatives with corporate strategy. Establishes project standards and mentors team members.

Monitors and improves Federal Employee Program healthcare operations, including utilization, case, medical, and disease management. Coordinates cross-functional teams, analyzes operational data, supports claims and customer service improvements, documents workflows, and reports performance. Assists with compliance audits, regulatory adherence, and fraud, waste, and abuse investigations. Requires travel to training programs, meetings, and conferences and supports daily business operations.

Analyzes enterprise-wide financial performance, develops reporting frameworks and complex forecasting models, manages budgets, and creates strategic reports and presentations. Transforms financial reporting systems and collaborates with leadership to improve visibility into business trends, P&L drivers, and resource allocation.

Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams using financial and enrollment data. Maintains financial models, performs variance analysis, supports accurate revenue recognition, and ensures compliance with regulatory guidelines. Documents reconciliation procedures, identifies process improvements, collaborates with actuarial, finance, compliance, and operations teams, and provides informal guidance to new team members.

Analyzes and forecasts payer revenue streams, including premium revenue and risk adjustment payments. Develops financial models, performs variance analysis, interprets enrollment and financial data, and identifies revenue optimization opportunities. Ensures compliance with regulatory and internal reporting requirements, maintains reconciliation and audit documentation, recommends process improvements, collaborates with actuarial, finance, compliance, and operations teams, and mentors junior analysts.

Analyzes premium revenue, risk adjustment payments, enrollment, and other financial data. Runs reports and models, validates information, performs actual-versus-projected revenue variance analysis, researches regulatory and market impacts, and supports reconciliation, compliance, documentation, and audit requirements.

Lead QA efforts for medium-to-large projects: analyze requirements, create test strategies, plans, and cases; manage test execution, environments, and defect lifecycle; report metrics; promote test automation and shift-left practices; mentor QA team and participate in Agile ceremonies.