Program and Project Management Responsible for strategic and tactical planning of HMSA's approach to delivering excellent performance and value for Federal Plan 87 and providing clear leadership, training, guidance, and coordination to all HMSA and partner/vendor resources supporting Federal Plan 87. Responsible for managing and cultivating HMSA's relationship with OPM, a

Strategic planning and project management. Collaborate with cross functional teams to develop comprehensive marketing plans and multiplatform campaigns to engage target audiences. Contribute to the development and implementation of various marketing plans, best practices, and guidelines. Contribute to strategic marketing plans to promote HMSA's brand. Collaborate with lea

Sales Activities Meet established marketing plan goals and achieve annual sales revenue and membership growth objectives by effectively promoting and closing prospective sales opportunities. Must generate robust sales activities including self generated marketing and email campaigns, outbound calls to assigned existing lead lists. Perform quick and efficient transaction f

Design, develop and operationalize new clinical integration programs for key partners in market. Will act as primary program lead for value based deals and special provider projects. Design, develop and operationalize next generation payment models for key partners in market. Will collaborative build next gen models with key ACOs leaders / PO leaders and high value physic

Manage HMSA's social media profiles and presence. Create, manage, and grow HMSA's business presence across relevant social media channels, including, but not limited to Facebook, Instagram, X (formerly Twitter), LinkedIn, Yelp, and YouTube. Evaluate new social media channels for appropriateness and integrate into the HMSA suite of social media platforms. Responsible for s

Revise and/or develop medical policies in conjunction with assigned medical director and in accordance with Development and Approval of Medical Policy administrative policy; process includes appropriate and timely implementation and publication. Support MM sponsored meetings by preparing and distributing an agenda, minutes, and documents to be discussed, and taking minute

Establishes relationships with business partners and the IT organization in order to provide technical solutions to meet user needs and influence strategic initiatives. Responsible for leading the analysis of IT requirements, alignment of IT resources and processes in order to meet the clients' organizational needs, as well as the design of enterprise solutions. Responsib

Assists in the implementation of care coordination and nursing duties within the scope of education, knowledge and experience and with appropriate supervision by a physician. Examples of duties include, but are not limited to, measuring and recording vital signs, performing routine screening tests, performing basic lab tests and EKGs, preparing and administering medicatio

Investigator Team Leadership and Support Perform Investigator staff oversight, and coaching on day to day investigation activities including, but not limited to FWA case reviews and approvals, regulatory referrals, documentation, reporting, overpayment processing and prevention. Facilitate and lead Investigator level meetings to resolve operational issues, brainstorm FWA

Leadership Identify, initiate, and manage organization wide projects to ensure that all HMSA's Medicare Program contractual obligations are met or exceeded. Manages necessary changes to existing systems, operations or workflows to address new/revised requirements of CMS/DHS/MQD. Structures work plans and project scope to deliver business impact on high priority issues. Ad

Prioritizes approved invoices and check requests according to payment terms. Familiarizes with company policies and navigating steps in Dynamics GP, Certify and CentreSuite. Verifies approver's level of authority to ensure that the cost center and the amount being charged are authorized. Follows through with requestor and obtains appropriate approval as needed. Validates

Quality Improvement Operations Provide direction and manage HMSA's overarching Quality Improvement program, including the oversight of staff and necessary resources required to design and implement programs related to compliance with accreditation, regulatory and program requirements (e.g., NCQA, Med QUEST, CMS, OPM, etc.). Oversee project teams and provide guidance to su

a. Project management and facilitation Develops and maintains project plans, timelines, and scope documents for strategy initiatives. Proactively manages deliverables, timelines, and budget Monitors and takes appropriate action to ensure various task and system related deliverables are accomplished in an accurate and timely manner. Develops strategies and tactics based on

a. Helps to lead and contributes to strategic design, implementation, and management of strategy roadmaps, strategic frameworks, and initiatives. Works with key stakeholders to strategically design and implement strategy initiatives with guidance from executive sponsors, subject matter experts, and other staff as needed Utilizes systems thinking to ensure strategies are d