Medical Management Vendor Relations Analyst

$53,000 - $99,000/Yr

Hawaii Medical Service Association - Honolulu, HI

Full-time - Mid Level

Hybrid - Honolulu, HI

Insurance Carriers and Related Activities

About the position

The Medical Management Vendor Relations Analyst plays a crucial role in supporting the development, implementation, and management of vendor relations, particularly for utilization management vendor partners. This position involves coordinating efforts with various departments and strategic partners to ensure compliance with contractual and accreditation requirements while enhancing operational efficiency.

Responsibilities

• Assist in the development, implementation, and management of vendor relations for utilization management.
• Coordinate efforts with key departments such as Medical Directors, Provider Services, and Compliance and Ethics.
• Manage deliverables of utilization management programs by delegated vendors, ensuring compliance and documentation are complete.
• Develop data templates and maintain program documentation for auditing purposes.
• Analyze business issues and troubleshoot workflow issues, providing recommendations to management.
• Prepare project reports and status updates for management and partners.
• Identify and implement opportunities for process improvement in workflows and operations.
• Present vendor program evaluations and audit reports to cross-functional committees.
• Facilitate quarterly UM file reviews and act as a liaison between vendors and HMSA departments.
• Provide training and consultation to vendor staff as needed.

Requirements

• Bachelor's degree and three years of work experience or equivalent combination of education and experience.
• Working knowledge in project management and coordination.
• Strong oral and written communication skills.
• Basic working knowledge of Microsoft Office applications, including Word, Excel, and Outlook.
• Experience with database and spreadsheet programs.

Nice-to-haves

• Experience in healthcare or medical management environments.
• Familiarity with NCQA UM standards and compliance requirements.

Benefits

• Hybrid work environment
• Competitive salary range of $53,000 - $99,000
• Opportunities for professional development and training