Medical Management Compliance Analyst

Job Summary

Hybrid Work Environment - Must reside on Oahu.

Full-time

Exempt

$59,000 - $116,000

Individuals typically begin between the minimum to middle of the pay range.

Conduct activities under minimal direction that support government regulations, accreditation standards and specific HMSA line of business requirements; lead/participate on project teams to share expertise and facilitate completion of deliverables.

• Bachelor's Degree and two years of related work experience; or equivalent combination of education and related work experience.
• Strong oral and written communication skills.
• Excellent analytical, organizational and time-management skills.
• Recognized leadership abilities.
• Proficient in the use of all Microsoft Office applications and Internet searches.

• Monitor and analyze regulatory/accreditation/business requirements to invoke recommendations for program and/or policy changes as appropriate for various lines of business.
• Lead/coordinate activities, which include internal audits, quality assurance control, quality improvement, provider satisfaction and department policies and procedures, to meet and/or maintain regulatory/accreditation/line of business requirements.
• Serve as a resource to internal and external staff regarding issues relating to administrative policies and procedures, medical policies, and researching and resolving problems.
• Edit all documentation generated by unit e.g., QIAs, reports, executive summaries, presentation materials, workplans, evaluations, annual plans, policies and procedures, minutes, agendas, provide feedback, and develop/generate monitoring reports/tools.
• Coordinate/schedule training opportunities and develop/present related reports and various documentation.
• Coordinate, support and document various department activities to ensure deliverables are completed by due date.
• Perform other duties (e.g., attend meetings) as assigned.