Hawaii Medical Service Association Medical Policy Analyst in Honolulu, Hawaii

Company:Hawaii Medical Service Assn.Job Title:Medical Policy AnalystExempt or Non-Exempt:ExemptIsland:OahuCity:HonoluluLocation:HonoluluEmployment Type:Full TimeJob Summary:Conduct activities under limited oversight that support government regulations, accreditation standards and specific HMSA line of business requirements.Duties and Responsibilities:

  • Revise and/or develop medical policies in conjunction with assigned medical director and in accordance with Development and Approval of Medical Policy administrative policy; process includes appropriate and timely implementation and publication.

  • Support MM sponsored meetings by preparing and distributing an agenda, minutes, and documents to be discussed, and taking minutes (meetings to include UMC, OMD, TEC, Drug Workgroup).

  • Assist with activities, which include internal audits, quality assurance control, quality improvement, provider satisfaction and departmental policies and procedures, to meet and/or maintain regulatory/accreditation/line of business requirements.

  • Research and respond to requests from internal departments/units requesting information on new technology (including research supporting TEC activities), medical procedures, drug therapies, DME, etc.

  • Serve as a resource to internal and external staff regarding issues relating to administrative policies and procedures, medical policies, and researching and resolving problems.

  • Conduct/schedule training opportunities and develop/present reports and various documentation related to MM activities.

  • Perform other duties (e.g., attend meetings) as assigned.

Minimum Qualifications:

  • Bachelor’s Degree and one year of related work experience; or equivalent combination of education and work experience.

  • Demonstrated verbal and written communication skills.

  • Proven analytical, organizational and time-management skills.

  • Proficient in the use of all Microsoft Office applications and Internet searches.

EEO/AA/Disability/Vets Employer