Senior Manager, Provider Reimbursements
HMSA
Job DescriptionOversee management and staff responsible for implementation and administration of Provider Reimbursement methodologies, including, but not limited to: Institutions, Professionals, and ancillary providers. Provide management reports and analysis needed for decision making, physician and institutional contracting, and ensuring adequate provider network access.Participate in provider negotiations to ensure that costs are within the anticipated budget.Administer operational activities to ensure compliance with par provider contractsServe as department leader on large, corporate-wide projects and programs that affect the organizations long term goals and objectives. Partner with management to determine projects/programs desired outcomes as it relates to corporate strategies.Recruit, train, and manage staff spanning across all areas of the entire Finance department. Develop and foster personal growth, learning, and accountability of the staff.Has oversight of the department's compliance policies, procedures, and internal controls in accordance with SSAE, CMS, MAR, SOC 2, BCBSA guidelines, and other regulatory requirements.Plan, schedule, measure and coordinate projects and tasks for unit and other business areas. Make decisions to control scope and resources, prepare documentation and ensure work flows are in accordance with our par contracts; through use of effective communication skills. Acts as a Lead Representative, presenting HMSA's case externally to the Fee review committee. Respond to ad-hoc data requests from management, executive staff, and external departments in relation to corporate goals and initiatives to HMSA's vision. Coordinates Finance duties for Physician fee reviews for all lines of businessEstablish and foster productive working relationships with internal and external parties by:Effectively conducting meetings and discussions to achieve collaboration, trust, and consensusAchieving service commitments from core and support functional areasPrioritizing, tracking, and managing deliverables.Assist in monitoring and planning for the department budget. Coordination of all Internal and External audits and implementation of control points for fee loading internally and with partners.Perform all other miscellaneous responsibilities and duties as assigned or directed#LI-HybridJob RequirementsBachelor's degree and six years related experience in financial reporting and/or data analysis, or equivalent combination of education and experience.Two years of supervisory/management experience.Effective written and verbal communication skills.Demonstrate knowledge in project management, planning, and organization.Job DetailsJob Type: Full-timeCategory: Supervisory / Management
- ...DescriptionManage CFR TeamYou are responsible for leading and managing the contracting function in Provider Services and overseeing the work of the employees in... ...with other HMSA departments (such as Professional Reimbursement, Claims Administration, Medical Management, BCIS...ReimbursementSeniorContract workWork experience placementWork at office
$99.75k - $214.37k
...portfolio . The team consists of Portfolio Managers, Underwriters, Credit Analysts,... ...an employee assistance program; fitness reimbursement; tuition reimbursement; an associate wellbeing... ...to inclusion and diversity and provide employment opportunities to all employees...ReimbursementSeniorLocal areaFlexible hours- ...Are you a Senior Project Manager in the Architecture, Engineering, and Construction field seeking... ...consultant needs and jurisdictional reviews Provide resolution to client and project... ...Welcome Box Casual Dress Code Reimbursement for Professional Licenses Paid Time Off...ReimbursementSeniorTemporary workFor contractorsCasual workWork at officeFlexible hours
$77.6k - $176k
Configuration Manager, Senior The Opportunity: As a change management expert on our team, you’ll be integral to establishing and delivering... ...At Booz Allen, we celebrate your contributions, provide you with opportunities and choices, and support your total well...SeniorFull timeContract workPart timeWork at officeLocal areaRemote work- Job DescriptionDevelop, analyze, recommend, and monitor reimbursement and provider strategies; prepare reports that measure the effectiveness of... ...data adjustments and workarounds.Propose resolutions to management to clearly define the increase in value and productivity associated...ReimbursementSeniorWork experience placementWork at office
- ...develop, and implement standard plans or provider financial and operational reports in... ...implement financial internal controls and risk management.Facilitate definition of data and other... ..., analyze, recommend, and monitor reimbursement and provider contracting strategies;...ReimbursementSeniorWork experience placementWork at office
- ...develop and implement standard plan or provider financial and operational reports in... ...develop reports to communicate findings to senior management.Participate in project workgroups;... ...Develop, analyze, recommend, and monitor reimbursement and provider strategies; prepare...ReimbursementSeniorContract workWork experience placementWork at office
$107.7k - $139.8k
...A leading electric utility provider is seeking a Senior Project Manager in Honolulu, Hawaii. The ideal candidate will possess extensive project management experience, especially in electric utility projects. Responsibilities include overseeing project initialization,...Senior$153.43k - $332.7k
...our people, our future, and what we stand for as a firm.KPMG is currently seeking a Tax Manager or Senior Manager to join our Business Tax Services practice. Responsibilities:Provide tax compliance and advisory services to pass-through entities and partnerships for a...SeniorLocal area$110k - $140k
...Job Description Job Description Senior Project Manager We are seeking a Senior Project Manager... ...‑performing team environment while providing mentorship and professional guidance.... ...development programs, including reimbursement allowances. Charitable match program...ReimbursementSenior16 hoursLocal area- ...environment.Your OpportunityStantec GS, seeks a Sr. NEPA Project Manager to support DoD work in the Pacific. This person will play an... ...timeJob Posting: 16/06/2025 04:06:37Req ID: REQ2500029JStantec provides equal employment opportunities to all qualified employees and applicants...SeniorWork at officeLocal areaWorldwide
$40 per hour
Join the Hilton team as a Senior Sales Manager selling for both Hilton Hawaiian Village and Hilton Waikoloa Village locations!Hilton Hawaiian... ...of world-class brands, and a company-wide commitment to providing the best stay for every guest, we’re setting new standards...SeniorTemporary workRemote workWorldwideNight shift- ...are seeking a highly skilled, hands-on Senior Consultant to join the Marketing Analytics... ...organization. Reporting to the Senior Manager of Marketing Analytics, this role combines... ...; communicating information and providing advice to drive projects forward; influencing...SeniorWork experience placement
- ...recognized as one of the region’s leading providers of integrated architecture and engineering services. Ourfederal project managers and engineers work collaboratively with Hawai... ...OverviewWe are currently seeking a Senior Federal Resources Project Manager - Engineer...Senior
- ...Function:Responsible to work with group, division, and department managers perform discovery in order to initiate, define scope, plan,... ...management; and identifying, securing, and managing required resources.Provides regular project progress reporting in accordance with team...SeniorWork at office
- ...Parexel is seeking a Senior Real-World Evidence (RWE) Analyst... ...hands-on coding versus project management or oversight... ...biopharmaceutical industry or provider/payer organizations Hands... ...delivery systems (e.g., payers and reimbursement models) Experience conducting...ReimbursementSeniorRemote workFlexible hours
- ...contract requirements. Description C3EL is seeking a cleared Senior Help Desk Manager to join our on-site team at Fort Shafter Flats in Honolulu, Hawaii. This position is responsible for managing and providing leadership to a tiered Help Desk team supporting multi-...SeniorContract workShift work
$132k - $198k
...buildings practice in Honolulu, HI, where you will manage and lead the growth of our Indo-Pacific delivery and execution hub. As a Senior Project Manager, you will play a pivotal... ..., cost-effective outcomes. This role provides a pathway to expand Stantec’s Federal DoD practice...SeniorContract workFor contractorsFor subcontractor$159.4k - $247.9k
...our professions. To meet this commitment, Cherry Bekaert will provide you with the space to pursue growth and development... ...Deal Advisory practice, an opportunity has been created for a Senior Manager to join our high performing team with the flexibility to sit...SeniorLocal areaRemote work- As a People Manager, this role provides leadership in planning, executing, and enhancing the Bank’s Enterprise Risk Testing (ERT) program. The position ensures testing activities are risk-based, compliant with regulatory requirements, and aligned with enterprise priorities...SeniorWork experience placementWork at office
- Position Function:Provide exceptional service to grow our business.Advocate our mission and be committed to creating value for our customers... ...and delight clients.Be the example and set high standards in managing client relationships.Risk Management/ComplianceLead the Team to...SeniorWork at office
$185k - $235k
...Entertainment, Inc. is North America’s leading provider of integrated entertainment, sports... ...and scalable solutions. About the Work: Manage the day-to-day activities of one or more... ...package. Education and conference reimbursement. Opportunities for career progression and...ReimbursementSeniorRemote work$90k
...New business development for LTL/LCL and FTL/FCL services. Provides face to face service to customers Works with Leadership to identify... ...exceeding revenue goals Grow and maintain customer base Manage customer interactions and information to ensure continuous and...SeniorNight shift$105k - $130k
...Senior Analyst, Life Sciences Consulting Company: Dedham Group... ...pharmaceutical solutions providers united under one goal: to improve... ...on projects addressing the reimbursement, pricing, demand creation,... ...Excellent time and project management skills ~ Superior skills in...ReimbursementSeniorFull timeTemporary workLocal areaRemote workFlexible hoursShift work$130.7k - $175k
...Job Overview: The Senior Manager, Environmental, Health and Safety (EHS) is responsible for providing multi-media environmental compliance leadership and support across... ...time), 401k with company match, Tuition Reimbursement, and Mileage Reimbursement Annual bonus...SeniorFor contractorsWork at officeLocal area$130k - $160k
...Senior Project Manager Location: Hawaii ECC is seeking candidates for a Senior Project Manager position for upcoming work in Hawaii and surrounding... ...and challenges. Confer with project personnel to provide technical advice and to resolve problems Manage issues...SeniorFull timeFor subcontractorWork at officeOverseasFlexible hours$100k - $110k
...locally headquartered grocery retail organization to recruit a Senior Accounting Manager to lead core accounting operations and financial close... ...and background Bishop & Company is a proud local firm providing recruitment services throughout Hawaii. There are no fees...SeniorWork at officeLocal areaRemote work$85k - $90k
...Middle East. Niagara’s mission is to provide our customers with innovative conservation... ...sacrificing performance. Summary Senior Marketing Manager is responsible for managing agency... ...Life insurance Paid time off Tuition reimbursement Vision insurance Schedule Monday to Friday...SeniorFull timeWork at officeRelocationMonday to FridayFlexible hoursWeekend work$130k - $165k
...Senior Project Manager Accounting & Finance Now Hiring: Senior Project Manager – Direct Hire Location: Honolulu, HI Company: NSC Staffing... ...Supervision Supervise and mentor project management staff. Provide leadership to ensure alignment across all project teams....SeniorContract workWork experience placementFor subcontractorWork at officeImmediate start$80k - $90k
...Senior Sales Manager Hotel Equities, a multi-award-winning hotel development and hospitality management company, is currently seeking an... ...profitable and win-win selling approach. It is essential to provide warm, knowledgeable service and helpful guidance to reassure...SeniorDaily paidWork at officeLocal areaImmediate startFlexible hoursNight shift
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