Network Management Specialist -- Medical Record Retrieval

HMSA
United States, Hawaii, Honolulu
818 Ke’eaumoku Street (Show on map)
April 13, 2024
Project Management and Administration Provides leadership to project to assure inclusion of data analysis, reporting capabilities and overall project scope is intact. Utilize project management techniques to research, document and coordinate activities to ensure deliverables are met. Perform network analysis that supports business operations and project management. Assist to define solutions that support business flows through use of workflow design/redesign. Monitor, evaluate, interpret, and disseminate program requirements related to risk. Ensure activities are conducted in accordance with applicable standards, line of business controls and requirements. Develop methods to improve daily operations and practice standards. Collaborates with external customers and clients (primarily key providers) to evaluate business needs. Escalate retrieval risks based on provider interactions appropriately. Problem solves solutions when barriers prevent provider compliance. Applications and Data Analysis Learn, acclimate, and engage in successful use of the providers EMR/EHR records system when applicable. Retrieve, download, and categorize patient records according to business needs. Communicate to providers scope of chart needs, deadline, available options for records submission, etc. Maintain accurate and detailed record of all engagement/interactions and attempts to contact providers in support of records request. Be able to audit against documentation and adapt format to best suit business needs. Ensure all provider communications are secure and records follow privacy guidelines. Relationship Management Develops, maintains, and nurtures strategic relationships with HMSA's network of health care providers and groups to successfully coordinate, retrieve and collect medical records for HMSA's Government Programs. Manages the day-to-day tactical objectives and tight timelines associated with ensuring 100% record retrieval accuracy. Problem solves any provider barriers which may prohibit compliance. Ensures clear communication w/providers and stakeholders on a daily basis. Reports and Presentations Produces written progress reports in a structured and informative manner. Ensure annotations are accurate, concise, clearly stated, and appropriate for internal audiences to understand. Collaborates with external customers and clients (primarily physicians and clinic administrators) to evaluate business needs. Network Management Representative Function as a Network Management Representative outside of the chart retrieval project timeline and/or based on availability in order to supplement network needs of Provider Operations. Other Duties/Functions Performs all other miscellaneous responsibilities and duties as assigned or directed. #LI-Hybrid