Jobs at HMSA

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.

Supports Medical Management through reporting, analytics, business and system requirements gathering, system implementation, testing, user support, training, and solution development. Coordinates department activities, access management, equipment requisitions, and issue resolution across departments. Maintains knowledge of regulatory reporting requirements, workflows, utilization management systems, and reporting applications while providing recommendations to business owners.

Leads enterprise HR analytics and AI initiatives, including predictive modeling, workforce planning, HR data integration, BI reporting, and responsible AI deployment. Owns the HR analytics data platform, governance, dashboards, and executive insights. Partners with HR, Finance, Operations, and clinical stakeholders to support workforce and organizational decisions. Recruits and develops an analytics and AI team while advancing SQL, programming, machine learning, prompt engineering, and analytics communication capabilities.

Manage and oversee call center quality assurance: conduct live and recorded call reviews, ensure consistent scoring and compliance, coach agents, analyze QA and training effectiveness, lead QA staff, produce performance reports, and recommend process and training improvements to enhance customer experience.

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.

Lead end-to-end product strategy, development, filings, and implementation for a commercial benefits segment. Manage cross-functional launches, regulatory compliance, performance monitoring, client-facing consultations, and ongoing product maintenance and documentation.

The Manager, Actuarial Pricing leads pricing recommendations, manages product updates, ensures data quality, and collaborates with stakeholders for product development.

Manages multiple high-level cross-departmental programs, ensuring successful planning, execution, and monitoring while fostering stakeholder relationships and facilitating communication.

The Senior Accounting Analyst performs complex financial analyses, manages compliance reporting, approves account reconciliations, leads process improvements, and facilitates cross-departmental communication.

Lead support for unified communications infrastructure, including planning, implementation, maintenance, and troubleshooting. Coordinate with vendors and business units, provide technical expertise, and ensure service levels are maintained. Mentor junior staff and participate in on-call support.

Lead provider reimbursement operations including methodology implementation for institutions, professionals, and ancillaries; manage staff; provide financial analysis and reporting for contracting and network access; participate in negotiations; ensure compliance with contracts and regulatory standards; coordinate fee reviews, audits, budgeting, and cross-functional projects; respond to ad-hoc data requests and represent the organization externally.

Lead category strategy, strategic sourcing, and vendor governance for business services. Manage RFx events, negotiate service contracts, drive cost savings, oversee vendor performance, analyze spend, support budgeting, and partner cross-functionally to ensure compliant contracts and value realization.

Lead IT category strategy, strategic sourcing, and vendor governance for SaaS, cloud, infrastructure, telecom, and managed services. Drive contract negotiations, cost optimization, cloud consumption and license management, vendor performance oversight, and cross-functional collaboration with IT, legal, finance, and risk to deliver measurable savings and compliance.