Medical Management Policy and Research Analyst II

Hmsa - Honolulu, HI

Full-time

Honolulu, HI

Insurance Carriers and Related Activities

About the position

The Medical Management Policy and Research Analyst II role at HMSA involves revising and developing medical policies in collaboration with the assigned medical director. The position requires timely implementation and publication of these policies, as well as support for various meetings and internal audits to ensure compliance with regulatory standards. The analyst will also research new technologies and medical procedures, serve as a resource for internal and external staff, and conduct training opportunities related to medical management activities.

Responsibilities

• Revise and develop medical policies in conjunction with the assigned medical director.
• Support MM sponsored meetings by preparing and distributing agendas, minutes, and documents, and taking minutes during meetings.
• Assist with internal audits, quality assurance control, quality improvement, and provider satisfaction to meet regulatory requirements.
• Research and respond to requests for information on new technology, medical procedures, drug therapies, and DME.
• Serve as a resource for internal and external staff regarding administrative policies, medical policies, and problem resolution.
• Conduct and schedule training opportunities and develop reports related to MM activities.
• Perform miscellaneous responsibilities and duties as assigned.

Requirements

• Experience in medical policy development and implementation.
• Strong research and analytical skills.
• Ability to prepare and present reports and documentation.
• Knowledge of regulatory and accreditation requirements in healthcare.

Nice-to-haves

• Experience with quality assurance and quality improvement processes.
• Familiarity with medical technology and drug therapies.