The Role
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.
Summary Generated by Built In
Job Summary & ResponsibilitiesPreferred Qualifications
- Reporting, Research & Analysis
- Analyzes and forecasts premium revenue, risk adjustment payments, and other revenue streams related to lines of business using prescribed guidelines or policies.
- Gathers, validates, and interprets financial and enrollment data from internal and external sources.
- Supports RAF and financial data needs of program driving accurate coding and documentation to optimize revenue from evaluation and interpretation of the information.
- Runs and maintains financial models to assess the impact of regulatory changes, enrollment trends, and market dynamics on revenue.
- Variance analysis: identify and explain variances between actual and projected revenue.
- Collaborates with actuarial, finance, compliance and operations teams to ensure accurate revenue recognition and reporting.
- Compliance & Documentation
- Ensure all revenue analysis and reporting adhere to internal policies and regulatory guidelines.
- Develops and maintains appropriate documentation of desktop procedures for reconciliation and audit needs.
- Maintains working level knowledge of revenue structures and regulations.
- Leadership & Continuous Improvement
- Identify gaps and assist in implementing process enhancements to improve the accuracy and efficiency of revenue analysis.
Provide informal guidance to new team members.
- Identify gaps and assist in implementing process enhancements to improve the accuracy and efficiency of revenue analysis.
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
#LI-Hybrid
- Bachelor's degree and four years of related experience; or an equivalent combination of education and related work experience.
- Strong oral and written communication skills for presenting complex information.
- Working knowledge of the techniques used to present financial or statistical data.
- Working knowledge of claims, health plan financial data, and health industry structure.
- Intermediate working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.
Skills Required
- Bachelor's degree and four years of related experience, or equivalent combination of education and related work experience
- Strong oral and written communication skills for presenting complex information
- Working knowledge of techniques used to present financial or statistical data
- Working knowledge of claims, health plan financial data, and health industry structure
- Intermediate working knowledge of Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint
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.
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The Company
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.
