Direct Contracting Manager TriWest Healthcare AllianceDirect Contracting ManagerHonolulu, HIRemoteFull timeMedicaid, Medicare, TRICARE, VAPC3), and the insurance industry; skill in diplomacy and negotiation; skill in financial analysis to analyze contractual reimbursement; skill in project management; skill in presentation; proficient with Excel. Develops hospital, physician and ancillary service agreements, ensures adherence with government operational manuals, monitors network shortfalls, and resolves access issues throughout the assigned region.
Salesforce Health Cloud Architect TriWest Healthcare AllianceSalesforce Health Cloud ArchitectHonolulu, HIRemoteFull timeTechnical Skills: General knowledge of data communication architectures, design, and support; General knowledge of the technology impacts on business and how to integrate technical plans to support enterprise business function; Business problem-solving skills; Understanding of project management concepts and techniques, including metrics. Works directly with Salesforce Health Cloud development teams, administrators and 3rd party vendor partners to provide expert technical direction, instruction, and leadership around complex technical concepts.
Director, Referral Management TriWest Healthcare AllianceDirector, Referral ManagementHonolulu, HIRemoteFull timeCollaborates with Utilization Management Director, MVS Directors, network providers, Military Treatment Facilities and TRICARE Regional Office West regarding TriWest's RM program initiatives including submission, review, optimization and return of clinical documentation processes. In collaboration with our Military & Veteran Services (MVS) leadership team and the Clinical Operations Utilization Management team, the Director develops strategies for achieving annual Referral Management goals and objectives, including input on system configuration and process development.
Customer Service Rep - Spanish Fluency Required TriWest Healthcare AllianceCustomer Service Rep - Spanish Fluency RequiredHonolulu, HIRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Utilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerHonolulu, HIRemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
Senior Buyer TriWest Healthcare AllianceSenior BuyerHonolulu, HIRemoteFull timeAssists departments in obtaining pricing and other information from vendors as well as reviews contracts and assists business units in the management of contractual obligations of the vendor to ensure that all terms and conditions are met. Act as SME in support of Procurement, Contract Management, DHA/ VA Contract Modification, Finance and business teams in support of pricing efforts including ROMs, RFIs/ RFPs, contracts, and licensing agreements.
Data Engineer TriWest Healthcare AllianceData EngineerHonolulu, HIRemoteFull timeTechnical Skills: Strong knowledge of data warehouse design; data modeling; proficiency with SQL; strong experience with data extraction, transformation, and loading (ETL); working knowledge of report and dashboard development; strong knowledge of SQL Server / Snowflake databases; working knowledge of Oracle databases. • Bachelor's Degree in Business Administration, Computer Science, Mathematics, Engineering, or related field with programming and database systems coursework or equivalent database development experience.
Business Analyst Sr TriWest Healthcare AllianceBusiness Analyst SrHonolulu, HIRemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. The position collaborates to ensure relevant analysis and complete, timely reporting is provided to meet TriWest business needs and Government's Healthcare requirements.
Provider Reimbursement Analyst TriWest Healthcare AllianceProvider Reimbursement AnalystHonolulu, HIRemoteFull timeThis role requires knowledge of healthcare coding and reimbursements, strong analytical skills, ability to work with large multi-dimensional sets, an ability to identify negative and positive trends, and strong communication skills that enable clear communications to leadership regarding findings. • Works closely with Provider Services and Finance leadership and SMEs on process and quality improvement strategies and/or provider education efforts, resulting from claims data analyses and findings.
Sales Group Manager - Enterprise Agentic AI Leader Intuit IncSales Group Manager - Enterprise Agentic AI LeaderHonolulu, HIRemote$214,500–$290,500 / yearCategory Sales Location Remote - New York - United States; Remote - California (Bay Area) - United States; Remote - California (Not Bay Area) - United States; Remote - Colorado - United States; Remote - Hawaii - United States; Remote - Illinois - United States; Remote - Maine - United States; Remote - Maryland - United States; Remote - Massachusetts - United States; Remote - New Jersey - United States; Remote - New York - United States; Remote - Ohio - United States; Remote - Texas - United States; Remote - Vermont - United States; Remote - Virginia - United States; Remote - Washington - United States; Remote - District of Columbia - United States Job ID 24158. You will partner with Firm Engagement Managers, Marketing, Product, and Channel to define how Intuit sells and delivers its Forward Deploy co-build model at scale, and you will be the connective link between your team''s work in the field and Intuit''s senior leadership.
Supervisor, Contact Center TriWest Healthcare AllianceSupervisor, Contact CenterHonolulu, HIRemoteFull timeEnsures accurate completion of VA-approved medical authorizations, appointment scheduling, thorough documentation of all Veteran and provider encounters in the TriWest medical management system and receipt of timely medical documentation from network providers. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Customer Service Rep (AZ, CO, ID, MT, NM, NV, OR, UT & WA only) TriWest Healthcare AllianceCustomer Service Rep (AZ, CO, ID, MT, NM, NV, OR, UT & WA only)Honolulu, HIRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Manager, Government Accounting TriWest Healthcare AllianceManager, Government AccountingHonolulu, HIRemoteFull timeThe Government Accounting Manager leads program financial management activities across multiple federal contracts, contract line items, and contract modifications, ensuring compliant general ledger operations aligned with company policy, company disclosed accounting practices, FAR, DFARS, and CAS. As a key business partner to Budget, Contract Management, Procurement, and Human Capital teams, the manager ensures accurate financial reporting and supports program execution by ensuring general ledger reporting is relevant and reliable.
Customer Service Representative (AR, IL, IA, KS, LA, MO, MN, NE, ND, OK, SD & WI) only TriWest Healthcare AllianceCustomer Service Representative (AR, IL, IA, KS, LA, MO, MN, NE, ND, OK, SD & WI) onlyHonolulu, HIRemoteFull timeAccurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.
Dir, Bus Design & Prod Mgmt TriWest Healthcare AllianceDir, Bus Design & Prod MgmtHonolulu, HIRemoteFull timeThis position requires in-depth knowledge and expertise in all aspects of TriWest's business contracts and provides cross-functional leadership and design as needed to adjust to a constantly changing environment. The Director of Business Design and Product Management oversees multiple operational support teams including Business Design and Integration (BDI) and Product Management.
Senior Clinical Coding Analyst TriWest Healthcare AllianceSenior Clinical Coding AnalystHonolulu, HIRemoteFull timeIndependent Thinking / Self-Initiative: Critical thinkers with ability to focus on things which matter most to achieving outcomes; commitment to task to produce outcomes without direction and to find necessary resources. Conducts retrospective medical claims review for coding and pricing determinations and/or coding review for inpatient (facility) claims to include diagnosis and procedural coding with DRG assignment.
Project Analyst/Assistant Brown and Caldwell IncProject Analyst/AssistantHonolulu, HIRemote$64,000–$87,000 / yearIn the event a recruiter or agency submits a resume or candidate without a previously signed agreement and approved engagement request with Brown and Caldwell, Brown and Caldwell reserves the right to pursue and hire those candidate(s) without any financial obligation to the recruiter or agency. We strive to be the company of choice-to our clients, who benefit from our passion for delivering exceptional quality, and to our employees, present and future, who share our commitment to client service, collaboration, and innovation.
Sr. Solutions Consultant - SDDC SHI GmbHSr. Solutions Consultant - SDDCHonolulu, HIRemote$150,000–$180,000 / yearSolutions Consultant - SDDC will assist SHI's customers in the post-sales implementation of data center infrastructure automation initiatives (Software-Defined Data Center) as clients move towards modern data center solutions and private clouds. Ability to understand and manage various infrastructure components (firewalls, load balancers, hypervisors, storage, monitoring, security) and use orchestration tools to develop comprehensive technical solutions - Advanced.
Remote Flexibility for Detail-Oriented Helpers AO Garcia AgencyRemote Flexibility for Detail-Oriented HelpersKailua, HawaiiRemoteWe may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. You are paired with a growing team, given tools and mentorship, and expected to enroll and support clients who asked for guidance.
Virtual - Client Portfolio Specialist AO Garcia AgencyVirtual - Client Portfolio SpecialistHonolulu, HawaiiRemoteWe may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. You are paired with a growing team, given tools and mentorship, and expected to enroll and support clients who asked for guidance.