Resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by Researching and collaborating with other units or departments to find a solution Accurately updating member records Contacting external partners who provide services for/to HMSA's

Performance Proactively service and grow HMSA products and services through various methods including site visits, on line meetings, telephone and email correspondence, power point presentations, and one on one customer servicing. Protect HMSA's market share through the successful renewal and retention of assigned accounts by strategically aligning HMSA's value propositio

Support the development of new products and benefits by performing the analysis and coordinating the efforts of others to produce the necessary information to be used in decision making by HMSA leadership. Produce comprehensive assessments of proposed changes through collaborative efforts with internal partners and subject matter experts. Prepare financial, brand, regulat

Execute, monitor, and lead implementation of payment integrity strategy. Assess the success of payment integrity activities for continued alignment with organizational goals (e.g., Healthcare Cost Trend) and ensure expected results are being achieved. Communicating external teams' outcomes, data analysis, complex processes and action plans to internal teams. Provides vend

Manages community health by establishing and maintaining trusting relationships with individuals, families, and providers to promote health, recovery, resiliency, and wellness. Advocating in members and families' best interests to ensure needs/choices are accurately represented/supported, and that timely care/services are delivered. Performs screenings/assessments regardi

Performance Manage Union Pod to stated performance metrics and goals. Create a performance oriented culture. Develop and implement account plans to leverage employer groups' objectives and how HMSA products fit into their benefit program. Use exceptional selling skills to promote and implement products and services through various methods, including site visits, correspon

Coordinate and deliver training programs using an appropriate mode (in person or virtual) to provide understanding of department technology and workflows, relevant laws, and HMSA plans and benefits. Manage logistics of training including planning, scheduling, and preparation of necessary tools and materials. Assist the department with daily business operations and functio

Stakeholder Management Build strong relationships with stakeholders at all levels, understanding their needs, and ensuring clear communication throughout the product development lifecycle. Understand stakeholders' vision, goals, mission, gaps, and opportunities and deliver technical products that are aligned with stakeholders' needs. Level set stakeholders' expectations a

Stakeholder Management Build strong relationships with stakeholders at all levels, understanding their needs, and ensuring clear communication throughout the product development lifecycle. Understand stakeholders' vision, goals, mission, gaps, and opportunities and deliver technical products that are aligned with stakeholders' needs. Level set stakeholders' expectations a

Maintain thorough knowledge of HMSA's provider network and the business with focus on provider contracts and reimbursement methodologies while working collaboratively across departments and our vendor partners to identify, document and maintain business requirements necessary for successful implementation. Researches the current state of HMSA's systems to include QNXT & C

Assist the Director to implement Credit Union policies, procedures and practices which include the organization's financial goals, objectives, and budgets. Make business improvement recommendations and coordinate with the Director to seek approval from the Board of Directors. Facilitate, organize, and plan all board meetings, credit union annual dinners and annual busines

Cross Functional Project Team Participation Assist project staff and subject matter experts with the planning and implementation of project and sub project work efforts. Work with stakeholders in the initial project planning stage to help set project objectives and success measures. Provide expertise to project managers for business or data requirements as well as ongoing

Manages community health by establishing and maintaining trusting relationships with individuals, families, and providers to promote health, recovery, resiliency, and wellness. Advocating in members and families' best interests to ensure needs/choices are accurately represented/supported, and that timely care/services are delivered. Performs screenings/assessments regardi

Performance Develop and implement account plans to leverage employer groups' objectives and how HMSA products fit into their benefit program and help them to accomplish their business goals. Use exceptional selling skills to promote and implement products and services through various methods, including site visits, correspondence, telephone, email/internet, power point pr

Develops and implements the risk management program in a manner that fulfils the mission and strategic goals of the organization. Complies with organizational policies, state and federal laws and accreditation standards related to corporate compliance, safety, security and risk management. Develops and implements systems, policies and procedures for the identification, co