Develops and implements the risk management program in a manner that fulfils the mission and strategic goals of the organization. Complies with organizational policies, state and federal laws and accreditation standards related to corporate compliance, safety, security and risk management. Develops and implements systems, policies and procedures for the identification, co

Collect, analyze, and utilize data and feedback related to Claims to identify opportunities to improve the relationship between the business and the other entity. This will include direct communication and participation with the Vendor Management Office (VMO) and Transformation Management Office (TMO). Compile reports about incidents, events, and updates regarding claims

Customer Experience Manage customer traffic levels and associate resources to ensure that the center is adequately staffed and operating efficiently. Ensure customers are being greeted and serviced appropriately while visiting the HMSA Center. The Lead Associate is required to extend and supplement the job duties expected of a Neighborhood Center Associate whenever necess

Customer Experience Provide all customers with an exceptional customer focused and positive HMSA Center experience. Ensure that the experience meets the customer's needs and exceeds their expectations. Communicate and promote HMSA's brand message and commitment to service excellence. Build enduring relationships with HMSA's customers/members and other consumers by becomin

Strategic Data Analytics and Project Management Understands and aligns enterprise and business unit goals, strategies, and objectives. Works with leadership to identify and prioritize D&A solutions which support goals, strategies, and objectives. Implements and oversees a Scope Management process that identifies, defines, and controls initiatives' deliverables and benefit

Create and design training material, online content and storyboards that simulate problem solving and on the job best practices. Work closely with and support the Staff Development team to create Internal Operations specific curriculum. Ensure the instructional integrity and educational effectiveness of all training materials produced. Demonstrate understanding of adult l

Responsible to prepare and coordinate the accounting and reporting for requirements of the ACA Prepares Statutory Health Care Exhibit (SHCE) report for the Association. Obtains information from various departments, documents processes and procedures, interprets and summarizes data, and completes report in accordance with Federal guidelines. Applies systematic, logical ana

Project Team Leadership Lead cross functional project staff, subject matter experts and vendor partners with the initiation, strategy setting, planning, and implementation of various business critical projects. Develop and analyze requirements, reports, policies and procedures and other formal documentation to meet regulatory compliance operations and oversight. Create an

Performance Meet established marketing plan goals, and achieve annual sales revenue and membership growth objectives by effectively promoting and closing prospective sales opportunities. Perform quick and efficient transaction fulfillment of telephone calls or email from prospective or current HMSA employer groups and members. Proactively promote HMSA and USAble product o

Responsibilities include, but are not limited to the following Influence information strategy By partnering with business unit leadership, and through the rationalization of the information value chain, the information architect will provide strategic recommendations to maximize the value of information assets via their creation, access and use. Maximize value derived fro

Customer Experience Provide all customers with an exceptional customer focused and positive HMSA Center experience. Ensure that the experience meets the customer's needs and exceeds their expectations. Communicate and promote HMSA's brand message and commitment to service excellence. Build enduring relationships with HMSA's customers/members and other consumers by becomin

Employee Relations Activities Maintains an understanding of the legal and business risks involved in all employee relations issues, including investigations, inquiries, and complaints. Records and produces notes based on this understanding, considering all applicable employment laws, regulations, and guidelines to ensure compliance and prevent liability. Creates, organize

Engagement, Assessment and Planning Engages members in the case management program (outreach and successful enrollment) using diagnostic cost group classifications or other tools which identify the relative risk score and illness burden. Identifying catastrophic health care users with significant health care costs is a priority. Conducts and documents a comprehensive asse

Lead the oversight and monitoring of the medical cost trend improvement efforts, by driving cross functional teamwork efforts to identify, design, implement, and monitor initiatives that moderate the Organization's healthcare cost trends Lead and manage a portfolio of activities with a sharp focus on enhancing healthcare cost outcomes through diversified mitigation strate

Responsibilities include, but are not limited to the following Leads and manages the Identity Access Management team. Acts as a point of escalation for any user or business stakeholder issues. Establishes and maintains relationships with business units throughout the organization so as to understand their working environments and communications needs. Recommends and overs