- Manage and lead a membership admin team by providing training, mentorship, and best practice solutions.
- Manage daily operations of the membership admin team, including inventory analysis, tracking and resolution
- Serve as the escalation point for complex or disputed cases and drive resolution within defined SLA.
- Monitor and analyze key performance indicators (KPIs) and take corrective actions to improve efficiency, accuracy, and customer satisfaction
- Collaborate with key stakeholders to include underwriting, LOB, legal, servicing teams to ensure a consistent and integrated approach to accurate and timely case processing.
- Maintain documentation, audit trails, and reporting in line with internal controls and external compliance requirements.
- Contribute to the development and implementation of new policies, procedures, and systems to improve membership admin operations.
- Stay current with changes in laws, regulations, and industry best practices related to membership admin management. Performs all other miscellaneous responsibilities and duties as assigned or directed.
- Bachelor's degree and five years of related work experience; or equivalent combination of education and related work experience.
- Two years of leadership, supervisory, or management experience.
- In-depth knowledge of managed care, PPO, HMO, Medicaid, Medicare Advantage, and commercial group health plans
- Working knowledge of claims adjudication systems (e.g., Facets, QNXT, Epic Tapestry, HealthEdge)
- Effective written and verbal communication skills
- Intermediate working knowledge of Microsoft Office applications including, but not limited to Word, Powerpoint, Outlook and Excel.
Skills Required
- Bachelor's degree and five years of related work experience
- Two years of leadership, supervisory, or management experience
- In-depth knowledge of managed care and health plans
- Working knowledge of claims adjudication systems
- Effective written and verbal communication skills
- Intermediate working knowledge of Microsoft Office applications
HMSA Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about HMSA and has not been reviewed or approved by HMSA.
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Healthcare Strength — Medical and dental coverage are described as solid, with preventive services and select zero‑cost features adding value in recent plan years. Employer-sponsored plans can have affordable premiums in certain groups and broad access options.
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Retirement Support — A 401(k) with company match and potential discretionary contributions forms a strong component of total rewards. Retirement support complements the core medical and dental package.
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Leave & Time Off Breadth — Paid holidays and PTO that increases with tenure provide meaningful time‑off flexibility. Time‑away benefits scale with service length.
HMSA Insights
What We Do
The Hawaii Medical Service Association (HMSA), an independent licensee of the Blue Cross and Blue Shield Association, is a reliable name in Hawaii health care. Established in 1938, we are the largest and most experienced provider of health care coverage in the state. Over half of Hawaii’s population have chosen HMSA for their health care coverage. We are dedicated to providing quality, affordable health plans; employee benefit services; and worksite wellness programs. HMSA also offers a variety of programs, services and support to help improve the health and well-being of our members and community.
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