Utilization Management Solutions Analyst II

HMSA; Honolulu (HI); Hybrid; USD 59,000 - 116,000; Full time

Job summary

HMSA in Hawaii is seeking a Business Solutions Analyst to support Utilization Management reporting and system analytics in a hybrid role requiring Hawaii residency. Pay range is $59k to $116k.

Responsibilities include documenting requirements, developing reporting tools, participating in system implementations, and providing user support across UM systems. Strong communication, organization, analytical skills, and MS Office proficiency are essential.

Qualifications

• Bachelor's degree and 2 years related work experience.
• Good verbal communication skills to present information before groups, departments, and management.
• Good written skills to compose business correspondence, policies & procedures, work plans, with high degree of accuracy.
• Good organization and time management skills.
• Good project management skills.
• Good business knowledge and experience.
• Strong analytical, organizational, and time-management skills.
• Strong analytical skills.
• Intermediate working knowledge of Microsoft applications including Word, Excel, Outlook and PowerPoint.

Responsibilities

• Support Medical Management (MM)'s business solution requirements for the department through data reporting from HMSA system applications and analytics.
• Solicit, document and/or clarify with business the reporting requirements and scope, including audience and summary requirements.
• Maintain knowledge of current regulatory reporting requirements and participate in internal calls and meetings.
• Maintain knowledge of current workflows for primary reporting requirements and attend meetings with business and user groups.
• Maintain knowledge of reporting software/applications used to support all reporting requirements.
• Participate in system implementation projects under the direction of the Senior Business Solutions Analyst and others.
• Solicit and document system and/or business requirements for a system solution, including participation in calls and workgroups.
• Develop tools to support Utilization Management activities (system configuration, test case development, testing).
• Provide feedback and escalate complex issues to the lead.
• Lead and coordinate activities to support department requirements; manage schedule, development, testing, and implementation.
• Provide system support to all users on the various utilization management systems.
• Resolve inquiries submitted to MM via email, calls and walk-ins; assist and escalate as needed.
• Organize and conduct training on how to utilize solutions.
• Coordinate and manage security and equipment requirements (access requests, purchase requisitions).
• Performs all other miscellaneous responsibilities and duties as assigned.

Skills

Verbal communication

Written communication

Organization

Time management

Project management

Business knowledge

Analytical skills

Microsoft Office proficiency

Education

Bachelor's degree and 2 years related experience

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Microsoft PowerPoint

Job description

Employment Type

Full-time

Exempt or Non-Exempt

Exempt

Job Summary

Hybrid Work Environment - Must reside in Hawaii**

Pay Range: $59k to $116k

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

Participate in and/or lead activities to support Utilization Management (UM) reporting requirements and all UM systems(s) and/or application users in the use, development, and implementation for the management of operational activities and system solutions

Minimum Qualifications

• Bachelor's degree and two years of related work experience; or equivalent combination of education and related work experience.
• Good verbal communication skills to present information before groups, departments, and management.
• Good written skills to compose business correspondence, policies & procedures, work plans, with high degree of accuracy.
• Good organization and time management skills.
• Good project management skills.
• Good business knowledge and experience.
• Strong analytical, organizational, and time-management skills.
• Strong analytical skills.
• Intermediate working knowledge of Microsoft applications, including but not limited to Word, Excel, Outlook, and PowerPoint.

Duties And Responsibilities

• Support Medical Management (MM)'s business solution requirements for the department through data reporting from various HMSA system applications and analytics utilizing established techniques or tools.
• Solicit, document and/or clarify with business the reporting requirements and scope to include but not limited to what question is the business trying to answer, intent of the detailed data, anticipated audience, and summary requirements.
• Maintain requisite knowledge of the current regulatory reporting requirements, including participation in relevant internal calls and/or meetings, researching and reading reporting guideline documentation.
• Maintain requisite knowledge of current workflows for primary reporting requirements, including participation in meetings with the business and/or user groups.
• Maintain requisite knowledge of reporting software / application used to support ALL reporting requirements through available documentation and/or attend trainings.
• Participate in system implementation projects under the direction of the Senior Business Solutions Analyst, Business Solutions Administrator and/or Information Management Manager.
• Solicit and document system and/or business requirements for a system solution to include but not limited to participation in calls, workgroups and/or meetings.
• Develop and/or assist in the creation of various tools to support Utilization Management activities which may include system configuration, test case development and/or testing.
• Provide feedback and/or elevate complex issues / concerns to appropriate lead.
• Lead and/or coordinate specific activities that support department requirements under the direction of Information Management Manager, Director or Vice President of the department.
• Manage the schedule, development, testing and implementation, as necessary, of the specific activity for the targeted audience(s).
• Maintain requisite knowledge of the specific activity; including participation in relevant internal calls and/or meetings, researching and reading updated material/documentation.
• Provide system support to all users on the various utilization management systems managed by Medical Management Department.
• Resolve inquiries submitted directly to MM initiated through email, calls and walk-ins.
• Assist Solutions Analyst with resolving more complex inquiries
• Elevate unresolved complex inquiries.
• Analyzes business problems and issues; coordinates input from various departments, units and/or staff to provide a recommendation or resolution to appropriate business owners.
• Organize and conduct training on how to utilize solutions, includes systems and/or applications administered or developed by the MM.
• Coordinate and manage the security and equipment requirements for the department.
• Completion, submission and tracking of access management requests.
• Completion, submission and tracking of purchase requisitions for computer equipment.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.