Medical Management Policy & Research Analyst I

Medical Management Policy & Research Analyst I #25-6073 Honolulu, Hawaii, United States

Employment Type

Full-time

Exempt or Non-Exempt

Non-exempt [Non-ex.]

Job Summary

**Hybrid Work Environment - Must reside in Hawaii**

Pay Range: $53,000 to $99,000

Note: Individuals typically begin between the minimum to middle of the pay range

Conduct activities under limited oversight that support government regulations, accreditation standards and specific HMSA line of business requirements.

Minimum Qualifications

• Associate degree and one (1) year of related work experience; or equivalent combination of education and work experience.

• Demonstrated oral and written communication skills.

• Proven organizational and time-management skills.

• Basic working knowledge of Microsoft Office applications, including but not limited to Word, Excel, Outlook, and PowerPoint.

Duties and Responsibilities

• Revise and/or develop medical policies adopted from the BCBSA 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.

• Assist with activities related to the revision and/or development of medical policies, code reviews, and TEC topic research, which include Service Now ticket submissions and Workfront ticket requests (tickets include data requests and medical policy page updates).

• Assist with the revision and update of MM C&S Unit assigned PRC pages. Collaborate with HMSA Communications Department with the accuracy of PRC page content and in the submission Workfront requests.

• 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, Policy Workgroup).

• Research and respond to requests from internal departments/units requesting information on new technology (including research supporting TEC activities) and medical policies.

• Performs all other miscellaneous responsibilities and duties as assigned or directed.

#LI-Hybrid