Job Description

Job Description

Job Description

Description

• Communicates directly with external partners and providers via phone, email or written correspondence in a professional, knowledgeable and timely manner to provide education; to obtain required documentation and/or clarification; and to provide direction in support of onboarding or provider claims inquiries.
• Coordinates with internal business for resolution of provider inquiries/issues related to onboarding into HMSA’s provider network, claims processing and benefits.
• Provides first-level contact for internal business areas to ensure that requests for field outreach are complete, actionable and if not, redirect accordingly. Monitors and analyzes case trends to proactively identify opportunities for improvement and/or development.
• Maintain and manage the Field unit’s outreach/planning calendar and project list to ensure compliance with all deadlines related to CMS, HEDIS, STARs etc. Actively work with management to develop additional workflows and reporting capabilities for Field outreach/project metrics.
• Develop, write, and maintain comprehensive documentation such as SOPs, communication guidelines, process flows, and project plans.
• Collaborate with various departments including data analysts to gather information, report findings, and ensure documentation is accurate, complete, and up-to-date.
• Document all aspects of the healthcare insurance operations, including interactions with the outsourcing partner.
• Ensure all documentation meets regulatory and compliance standards.
• Create user-friendly guides, manuals, and data analytic finds, for internal and external stakeholders - ensure analytic findings are understandable to leadership and other non-technical stakeholders.
• Review and edit existing documentation to improve clarity, consistency, and usability.
• Manage document control processes to ensure proper versioning and accessibility.
• Conduct regular audits of documentation to ensure ongoing accuracy and relevance.

WEST: #prioritywest

#westpriority25

Pay and Benefits

The pay range for this position is $26.00 - $29.00/hr.

Eligibility requirements apply to some benefits and may depend on your job
classification and length of employment. Benefits are subject to change and may be
subject to specific elections, plan, or program terms. If eligible, the benefits
available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully onsite position in Honolulu,HI.

Application Deadline

This position is anticipated to close on Sep 2, 2025.

h4> About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

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