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Job Details

Medical Management Compliance Analyst

  2025-10-22     HMSA     Honolulu,HI  
Description:

Responsibilities

  • 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.

Qualifications

  • 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.

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