Utilization Management Solutions Analyst II

Employment Type: Full-time, Exempt. Hybrid work environment – must reside in Hawaii.

Pay

$59,000 to $116,000. Individuals typically begin between the minimum to middle of the pay range.

Requirements

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

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, including but not limited to what question the business is trying to answer, intent of the detailed data, anticipated audience, and summary requirements.
• Maintain requisite knowledge of 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/applications used to support all reporting requirements through available documentation and/or attending 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, including 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 the appropriate lead.
• Lead and/or coordinate specific activities that support department requirements under the direction of the 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 the 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.
• Analyze business problems and issues; coordinate 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, including systems and/or applications administered or developed by 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.
• Perform all other miscellaneous responsibilities and duties as assigned or directed.