Healthcare Data & Policy Analyst I

hmsacareers; Honolulu (HI); On-site; USD 55,000 - 75,000; Full time

Job summary

HMSA in Honolulu, HI seeks a Healthcare Analyst I to support Research and Analysis, Benefit and Policy analysis, and New Code Implementation. You will respond to inquiries, utilize online information files and databases, and collaborate with clinical consultants, other Blue Cross/Blue Shield plans, and vendors.

You will learn to assess the business impact of new benefits and changes in medical or reimbursement policies, perform cost/benefit analyses, and prepare documentation to inform claims

Qualifications

• Bachelor's degree or equivalent combination of education and work experience.
• One year related work experience.
• Effective verbal, written communication skills
• Excellent organizational and analytical skills
• Good working knowledge of Microsoft Office applications.

Responsibilities

• Research and respond to low complexity internal and external inquiries.
• Use resources including online information files and databases, plus guidance from peers, interviews with internal departments and vendors.
• Assess business impact of new benefits and policy changes; conduct cost/benefit analyses; develop documentation for claims processing.
• Update and create CES pend resolutions and drive changes through work intake, cross‑department meetings, requirements review, testing validation and post‑implementation monitoring.
• Learn loading new codes (CPT, HCPCS, ICD-10) and prepare files for review and configuration implementation.
• Support audits of implemented policies and completed projects; identify cost increases and inequitable payments; document complex business scenarios for policy/workflow requirements.
• Attend HMSA Continuing Education training classes as assigned.
• Other duties as assigned.

Skills

Analytical skills

Verbal communication

Written communication

MS Office

Organizational skills

Education

Bachelor's degree or equivalent

Tools

Microsoft Office

Job description

HMSA in Honolulu, HI seeks a Healthcare Analyst I to support Research and Analysis, Benefit and Policy analysis, and New Code Implementation. You will respond to inquiries, utilize online information files and databases, and collaborate with clinical consultants, other Blue Cross/Blue Shield plans, and vendors.

You will learn to assess the business impact of new benefits and changes in medical or reimbursement policies, perform cost/benefit analyses, and prepare documentation to inform claims