Hawaii Medical Service Association Business Specialist II (Government Plans) in Honolulu, Hawaii
Company:Hawaii Medical Service Assn.Job Title:Business Specialist II (Government Plans)Exempt or Non-Exempt:ExemptIsland:OahuCity:HonoluluLocation:HonoluluEmployment Type:Full Time - Regular-On-ContractJob Summary:(ROC) Regular-on-Contract Two Years from Date of Hire
Develop professional skills and business knowledge geared toward progression into the Contract Compliance Coordinator, MS Operations Business Analyst, or Enrollment Business Management Coordinator positions. The Sr. Business Specialist II is responsible for ensuring overall understanding of Membership Service’s enrollment unit by:Coordinating and conducting audits of enrollment records and reports for government lines of business. This is to identify quality improvement items and recommend solutions to ensure data integrity and compliance with applicable laws, regulations, contractual performance standards as well as functional policies and procedures.Providing business operations with guidance regarding policy and procedures to ensure compliance with CMS regulations.Individual newly hired into this position is expected to meet satisfactory levels of the job functions within six months to a year. At that point management will determine whether this individual is qualified for progression into a position career-tracked for contract compliance, analyst, or management.Duties and Responsibilities:
Read, understand and interpret complex federal laws, regulations and bulletins, and analyze their impact on business operations. Assess business operational activities and evaluate operational processes to ensure compliance with applicable laws, regulations, contractual performance standards, and functional policies and procedures.
Audit/problem-solve enrollment records issues and related activities to ensure accuracy, completeness and timeliness.
Provide feedback and guidance to staff to ensure correct knowledge, understanding of policies, process and/or procedures.
Evaluate operations status and develop controls and/or procedure changes to ensure quality and performance standards are met.
Analyze and reconcile internal and external enrollment reports across the various systems/applications and operational areas. Identify quality improvement items and recommend solutions to ensure data integrity and compliance with applicable laws, regulations, contractual performance standards as well as functional policies and procedures. Responsible for the timely and accurate completion of reports required by CMS, executives and other management staff.
Engage in own professional development by identifying a preferred career path and proactively building toward it. Independently seek additional training and learning opportunities to expand skill set and address any deficiencies in the knowledge or competencies required for the desired career path.
Perform other duties as assigned.Minimum Qualifications:Bachelor’s degree and one year related experience; or equivalent combination of education and related work experience.Excellent verbal and written communication skills.Strong time and priority management skills.Strong problem solving skills.Proficient working knowledge of Microsoft Office applications.