- Bachelor's degree (B.A.) and 5 years of related work experience, or an equivalent combination of education and experience.
- 2 years of management/supervisory or leadership experience.
- Effective verbal and written communication skills.
- Experience leading diverse teams to meet organizational goals in matrix organizations.
- Skilled in driving change and innovative thinking.
- Basic knowledge of Microsoft Office applications. Including but not limited to Word, Excel, Outlook, and PowerPoint.
- Leadership
- Identify, initiate, and manage organization-wide projects to ensure that all HMSA's Medicare Program contractual obligations are met or exceeded.
- Manages necessary changes to existing systems, operations or workflows to address new/revised requirements of CMS/DHS/MQD.
- Structures work plans and project scope to deliver business impact on high priority issues.
- Addresses any identified deficiencies in current program quality and administration.
- Directs regular organization-wide training to develop staff in other key departments as subject matter experts on Medicare Programs.
- Meet as needed with the Vice President and Director to review progress, report key results and program performance measures and to reestablish priorities.
- Conducts regulatory analyses and facilitates requirement development, and implementation tracking.
- Contributes to the development of business strategies for the Medicare line of business.
- Effective management of staff
- Oversees and manages workflows to ensure that services and requests are handled consistently, effectively, and efficiently in order to minimize risks to members and the organization. Documents workflows and work processes.
- Responsible for ensuring that Medicare Programs contract is meeting requirements established by CMS.
- Performs various employee management functions including but not limited to; talent management, development, performance reviews, and handles any related adjustments to salary or job description.
- Prepares and analyses reports summarizing operational and financial performance of the team/programs.
- Coordination with external agencies
- Function as the management liaison between HMSA and Federal/State government representatives for CMS.
- Responsible for the development and tracking of all written and verbal communication between the Federal and/or State organizations.
- Acts as a liaison for Medicare programs with external entities.
- Other Duties/Functions:
- Performs all other miscellaneous responsibilities and duties as assigned or directed.
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Manager, Medicare Programs
1 week ago
HMSA Honolulu, United StatesLeadership · Identify, initiate, and manage organization-wide projects to ensure that all HMSA's Medicare Program contractual obligations are met or exceeded. · Manages necessary changes to existing systems, operations or workflows to address new/revised requirements of CMS/DHS ...
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Manager, Medicare Programs
2 days ago
HMSA Honolulu, United StatesFull-timeExempt · Hybrid Work Environment - Must reside in Oahu · Pay Range: $73,154 - $121,252, position is eligible for an incentive bonus · Note: Individuals typically begin between the minimum to middle of the pay range · The Manager, Medicare Programs has organization level ...
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Manager, Medicare Programs
4 hours ago
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Manager, Medicare Programs
4 hours ago
HMSA Honolulu, United StatesLeadershipIdentify, initiate, and manage organization-wide projects to ensure that all HMSA's Medicare Program contractual obligations are met or exceeded. · Manages necessary changes to existing systems, operations or workflows to address new/revised requirements of CMS/DHS/MQD. ...
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Project Manager, Medicare Programs
4 hours ago
Hawaii Medical Service Association Honolulu, United StatesJob Summary · **Hybrid Work Environment - Must reside in Hawaii** · Pay Range: $64,915 - $103,415 · Note: Individuals typically begin between the minimum to middle of the pay range · Responsible for complex project management related to the development and implementation of mul ...
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Project Manager, Medicare Programs
1 week ago
HMSA Honolulu, United StatesManage projects that involve research, analysis, planning, development, and implementation activities. Monitors the progress and timeline; communicating with project stakeholders, management, and other relevant parties. Will also focus on process improvement activities. Facilitat ...
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Project Manager, Medicare Programs
3 hours ago
HMSA Honolulu, United StatesManage projects that involve research, analysis, planning, development, and implementation activities. Monitors the progress and timeline; communicating with project stakeholders, management, and other relevant parties. Will also focus on process improvement activities. Facilitat ...
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Clinical Manager
6 days ago
BAYADA Home Health Care Honolulu, United States Full timeBAYADA Home Health Care is currently seeking a full-time Registered Nurse to become our next Clinical Manager in our Medicare certified Oahu Visits office in Honolulu, HI. As one of the Clinical Managers, you will lead the field staff in providing exceptional client service, clin ...
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Manager, Medicare Risk Adjustment
6 hours ago
HMSA Honolulu, United StatesFull-timeExempt · Hybrid Work Environment - Must reside in Oahu · Pay Range: $73,154 - $121,252, position eligible for an incentive bonus · Note: Individuals typically begin between the minimum to middle of the pay range · The Manager, Medicare Risk Adjustment has organization le ...
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Manager, Medicare Risk Adjustment
6 hours ago
Hawaii Medical Service Association Honolulu, United StatesJob Summary · **Hybrid Work Environment - Must reside in Oahu** · Pay Range: $73,154 - $121,252, position eligible for an incentive bonus · Note: Individuals typically begin between the minimum to middle of the pay range · The Manager, Medicare Risk Adjustment has organization le ...
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Business Analyst II
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HMSA Honolulu, United StatesJob Summary · Hybrid Work Environment - Must reside in Hawaii ** · Responsible to support the development and implementation of required activities to ensure compliance with Centers for Medicare and Medicaid Services (CMS) requirements and mandates, that ensures compliance with ...
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Director Patient Care Services
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Physician - Urology
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Queen's Health System Honolulu, United States Full timeRESPONSIBILITIES · Effective Date: 02/22 · I. JOB SUMMARY/RESPONSIBILITIES: · - Supervises the daily operations of the assigned area. · - Works collaboratively with management to ensure operations are in compliance with applicable regulatory requirements and with the policies and ...
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Clinical Manager
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Bayada Honolulu, United States· BAYADA Home Health Care is currently seeking a full-time Registered Nurse to become our next Clinical Manager in our Medicare certified Oahu Visits office in Honolulu, HI. As one of the Clinical Managers, you will lead the field staff in providing exceptional client service, c ...
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Manager, Medicare Risk Adjustment
6 days ago
HMSA Honolulu, United States Full timeJob Summary · **Hybrid Work Environment - Must reside in Hawaii ** · The Manager, Medicare Risk Adjustment has organization level responsibilities for the administration of all provisions/requirements of HMSA's Medicare Risk Adjustment program. They are responsible for managing ...
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Director of Referral Relations
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Director of Nursing
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Health & Well-Being Consultant
4 hours ago
Hawaii Medical Service Association Honolulu, United StatesJob Summary · **Hybrid Work Environment - Must reside on Oahu ** · Pay Range: $57,629 - $88,159,position is eligible for an incentive bonus · Note: Individuals typically begin between the minimum to middle of the pay range · Partners with HMSA's commercial employer groups to as ...
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Health & Well-Being Consultant
6 hours ago
HMSA Honolulu, United StatesFull-timeExempt · Hybrid Work Environment - Must reside on Oahu · Pay Range: $57,629 - $88,159, position is eligible for an incentive bonus · Note: Individuals typically begin between the minimum to middle of the pay range · Partners with HMSA's commercial employer groups to assi ...
manager, medicare programs - Honolulu, HI, United States - Hawaii Medical Service Association
Description
Job Summary**Hybrid Work Environment - Must reside in Oahu**
Pay Range: $73,154 - $121,252, position is eligible for an incentive bonus
Note: Individuals typically begin between the minimum to middle of the pay range
The Manager, Medicare Programs has organization level responsibilities for the administration of all provisions/requirements of HMSA's Medicare contracts/programs. Including but not limited to (Medicare Advantage, DSNP, and Part D) with the Centers for Medicare Medicaid Services (CMS).
Actively leading and directing the resources within the department to achieve program/contract goals and requirements. Will function as the operational business owner for the above and will represent Medicare Programs in meetings, presentations, reports, and audits with CMS and any other applicable regulatory, investigative, or government agencies.
Minimum Qualifications
Duties and Responsibilities
#LI-Hybrid
