Caring for the people of Hawaii is our promise and our privilege. Working together with employers, partners, and physicians and other health care providers, we promote wellness; develop reliable, affordable health plans; and support members with clear, thoughtful guidance.
HMSA is the most experienced health plan in the state, covering more than half of Hawaii’s population. As a recognized leader, we embrace our responsibility to strengthen the health and well-being of our community.
Vision A Hawaii where families and communities enjoy ever healthier lives.
Purpose Together, we improve the lives of our members and the health of Hawaii. Caring for our friends, families, and neighbors is our privilege.
Career Opportunities
HMSA is Hawaii’s leading provider of health care coverage. Our success is largely due to the quality and dedication of our employees.
Work When you work at HMSA, you make a difference in the lives of the people of Hawaii.
Play Having fun is vital! Spending time doing things you enjoy and living life to the fullest makes each day better.
Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements. Secures information from int...
Conducts critical analysis of highly complex and sensitive member and provider appeals, inquiries and grievances and applies internal policies and procedures, contractual provisions, and regulatory requirements. Secures information from int...
Manages community health by establishing and maintaining trusting relationships with individuals, families, and providers to promote health, recovery, resiliency, and wellness. Advocating in members and families' best interests to ensure ne...
Resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by: Researching and collaborating with other unit...
Resolve enrollment, eligibility and billing issues and inquiries timely and accurately from members, employer groups and third party administrators by phone, email and written correspondence by: Researching and collaborating with other unit...
Tactical Activities Responsible for the implementation of tactical workplace well-being plans for employer groups utilizing industry, national, and state best practices to increase employee participation and engagement. Assists in conductin...
Support day-to-day business operations and functions. This includes processing claims, member/provider servicing (both in-person and telephonically), identifying trends in operational efficiencies, researching inquiry escalations, and respo...
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 cen...
Utilize medical necessity criteria from established medical policies and clinical practice guidelines to render precertification determinations as described in the Medical Management UM work plan. This detailed clinical judgment includes ev...
Performance Use account data and critical thinking to effectively marry customer goals and objectives to HMSA's products and services. Achieve membership goals, quotas, and minimum activity standards. Manage RFI and RFP responses ensuring a...