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Business Analyst I - Medicare Programs

Job Summary:

**Hybrid Work Environment - Must reside in Hawaii **
Support the development and implementation of required activities to ensure compliance with Centers for Medicare and Medicaid Services (CMS) requirements and mandates that ensures compliance with Medicare contracting requirements.

Coordinate operational activities with appropriate department personnel; work with manager to establish work plans, target dates, track and monitor work items as requested. Assist in the execution of HMSA's corrective actions to meet performance standards and support other compliance focused activities.

Minimum Qualifications:
  1. Bachelor's degree and two years related work experience; or equivalent combination of education and experience.
  2. Effective oral and written communication skills.
  3. Strong work management and problem-solving skills.
  4. Effective analytical and interpretive skills.
  5. Intermediate working knowledge in Microsoft Office Word and Excel.
  6. Basic working knowledge in Microsoft Outlook and PowerPoint.

Duties and Responsibilities:
  1. Coordinate and monitor activities with appropriate MP and operational departments to ensure that standards are being met timely and accurately; escalate issues as needed. Conduct analysis of ad hoc and questions, research issues, and provide assistance to departments to assess impact and determine best course of action, and document decision/resolution.
  2. Responsible for supporting, monitoring, and reporting corrective actions in response to external/internal monitoring. Coordinate the day-to-day activities needed to comply with CMS requirements.
  3. Coordinate the regular production of unit reports. Work with others in MP and in related business areas to gather data, monitor trends, identify, and analyze anomalies. Track HMSA's compliance with CMS program standards, policies, and guidance through multiple sources, such as HMSA submitted reports to CMS, CMS generated performance metrics, and department self-reported issues.
  4. Monitor CMS regulations and provide operational areas with impact guidance on the impact to HMSA departments and contracted vendors regulations or standards. Work with MP Admin to adjust policies, procedures, and workflows to adapt to changing requirements and identified deficiencies in current program quality and administration. Then monitor compliance via report and data validation.
  5. Work with other MP Business Analysts to update Medicare Programs' and related operations policies, procedures, work plans and training to ensure that new processes are updated and documented.
  6. Performs all other miscellaneous responsibilities and duties as assigned or directed.
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Equal Opportunity Employer - Minorities/Women/Protected Veterans/Disabled