- Lead provider performance management activities. Monitor technical, process, and business outcome metrics across all provider contract requirements and Service Level Agreements (SLAs). Recommend actions for improvement and drive continuous improvement. Oversee and manage staff.
- Manage the performance governance aspects of provider services contracts. These activities include:
- Enforce compliance with the contractual SLAs and deliverables.
- Review and validate performance reporting.
- Capture potential value leakage and/or service level penalties.
- Coordinate implementation of SLA reporting automation.
- Generate dashboards and reports for executive level briefing.
- Develop and measure provider network performance metrics and objectives, such as:
- Cost, quality, and accessibility reporting.
- Network reporting supportive of open enrollment and RFP's.
- Ensure all regulatory network requirements are measured and reported according to listed requirements, such as:
- ACA, QUEST, Medicare, HMSA
- Oversee data analysis functions that support contract negotiations and fee reviews.
- Oversee out of network provider access strategies including:
- Single case agreements
- Network access partner solutions
- Perform 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.
- Three years of supervisory/management or leadership experience.
- Excellent oral and written communication skills.
- Excellent data analysis and reporting skills
- Strong understanding of legal and contractual terms used in provider contracts.
- Intermediate working knowledge of Microsoft Office applications. Including, but not limited to Word, Excel, Outlook, and PowerPoint.
Skills Required
- Bachelor's degree
- Five years of related work experience
- Three years of supervisory/management experience
- Excellent oral and written communication skills
- Excellent data analysis and reporting skills
- Strong understanding of legal and contractual terms used in provider contracts
- 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.
