Jobs at HMSA

The Provider Contracting Manager leads and implements HMSA's provider strategy, negotiates contracts, manages financial proposals, and builds relationships with providers and various departments.

Manage encounter submission program including coordination with LOB and finance, ensure compliance with risk-adjustment rules, oversee data reconciliation and vendor reporting, implement solutions, lead and develop team, produce internal/external reports, and drive continuous improvement.

The Senior Business Analyst will lead quality improvement initiatives, analyze data, manage cross-departmental projects, and communicate results to stakeholders.

The Business Analyst I provides production support, data analysis, triages issues, assists with projects, and develops training materials.

The Business Analyst will support quality improvement by analyzing data, managing projects, coordinating communication across departments, and developing evaluation reports.

The role involves analyzing, designing, and supporting application systems, managing projects, leading teams, and ensuring system efficiency. It requires extensive experience in application development and project management.

Manage Inter-Plan (BlueCard) program governance and policy interpretation, research and resolve complex claims using ITS/Blue2 and reference databases, coordinate communications and payments, produce and compile reporting, lead process improvements and training, liaise with multidisciplinary teams and vendors, and support national BCBS projects and initiatives.

Record, reconcile, and analyze financial transactions and balance sheet accounts, prepare accruals and supporting schedules, assist with subsidiary financial statements and audits, run ad-hoc reports, and lead accounting and system projects to improve workflows and ensure accurate month-end close processes.

Manage product strategy, development, regulatory compliance, and operational execution for commercial products. Collaborate with leadership and cross-functional teams to optimize portfolio and ensure successful implementation.

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

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 performance management activities, oversee compliance with SLAs, manage data analysis for provider contracts, and implement performance metrics.

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

The Analyst, Payment Integrity conducts research and analysis to support operations, assesses business impact of policies, and recommends process improvements.

Oversee encounter system processes, optimize submissions and ensure compliance with external partner requirements while leading projects and supporting reporting needs.

Serve as in-office service contact for assigned employer groups handling enrollment, billing, claims, delinquency, retro transactions, pre-enrollment, contracting, onboarding, and open enrollment. Coordinate with cross-functional teams, meet retention and service metrics, and support strategic account activities and documentation updates in QNXT.

Serve and grow assigned employer accounts by proactively managing renewals, retention, and sales of HMSA products; collaborate with Strategic Account Managers and internal teams; perform business analysis and proposals; educate clients on industry trends; maintain account plans and records; resolve complex service issues.

Provide in-office servicing for assigned employer groups: handle inquiries, coordinate GTB/certificate requests, validate SBCs and benefit summaries, update rates in QNXT, support open enrollment and onboarding, research delinquencies and retro transactions, collaborate with cross-functional teams, and meet retention and service metrics.

Lead planning, execution, and closure of IAM projects and programs. Develop requirements, manage resources and vendors, integrate project plans, monitor milestones/risks, report to stakeholders, and mentor team members to ensure projects meet scope, schedule, cost, and quality objectives.