Strategic Leader, Provider Reimbursements & Compliance

hmsacareers; Honolulu (HI); Hybrid; USD 120,000 - 170,000; Full time

Job summary

HMSA seeks a senior finance leader to oversee provider reimbursement methodologies and related operations in a hybrid Honolulu environment. You will manage a team, deliver management reports for contracting decisions, and lead cross-functional projects aligned with HMSA’s strategic goals.

Responsibilities include budget oversight, compliance with regulatory standards, and negotiating with providers to maintain cost targets. Excellent communication and project management skills are essential.

Qualifications

• Bachelor's degree and six years related experience in financial reporting and/or data analysis, or equivalent combination.
• Two years of supervisory/management experience.
• Effective written and verbal communication skills.
• Demonstrate knowledge in project management, planning, and organization.

Responsibilities

• Oversee management and staff responsible for implementation and administration of Provider Reimbursement methodologies, including Institutions, Professionals, and ancillary providers.
• Provide management reports and analysis needed for decision making, physician and institutional contracting, and ensuring adequate provider network access.
• Participate in provider negotiations to ensure that costs are within the anticipated budget.
• Administer operational activities to ensure compliance with par provider contracts.
• Lead department on large, corporate-wide projects and programs that affect the organization’s long-term goals.
• Plan, schedule, measure and coordinate projects and tasks for unit and other business areas; make decisions to control scope and resources.
• Establish and foster productive working relationships with internal and external parties; conduct meetings to achieve collaboration and consensus; prioritize, track, and manage deliverables.
• Assist in monitoring and planning for the department budget; coordinate internal and external audits and implement control points for fee loading.

Skills

Financial reporting

Data analysis

Project management

Planning

Organization

Leadership

Communication

Education

Bachelor's degree

Job description

HMSA seeks a senior finance leader to oversee provider reimbursement methodologies and related operations in a hybrid Honolulu environment. You will manage a team, deliver management reports for contracting decisions, and lead cross-functional projects aligned with HMSA’s strategic goals.

Responsibilities include budget oversight, compliance with regulatory standards, and negotiating with providers to maintain cost targets. Excellent communication and project management skills are essential.