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Salter Healthcare

RN Case Manager

Winchester, MA · On-site

$45 - $55/wk

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

Monitor level of care for HMO patients on admission and throughout their stay * Obtain prior approval for all HMO patients for transportation, therapy, and other services * Track HMO and Medicare ...

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Hmo information

What are the typical responsibilities of an HMO medical officer on a daily basis?

As an HMO Medical Officer, your daily tasks often include reviewing patient medical records for pre-authorization or claims, consulting with physicians and healthcare providers on case management, and conducting medical audits to ensure compliance with policies. You’ll also participate in utilization review meetings and help develop clinical guidelines to improve care quality and operational efficiency. This role is highly collaborative, requiring regular interaction with both clinical and administrative staff. By balancing clinical expertise with healthcare management, you play a key role in delivering effective and sustainable patient care within the HMO structure.

What is an HMO?

An HMO (Health Maintenance Organization) job typically refers to a role within a healthcare organization that provides managed care services to patients. Employees in HMO roles may work in various capacities, such as case management, claims processing, provider relations, or patient coordination. Their primary responsibility is to ensure efficient healthcare delivery while managing costs and maintaining compliance with healthcare regulations.

What are the key skills and qualifications needed to thrive in the HMO position, and why are they important?

To thrive as an HMO (Health Maintenance Organization) Medical Officer, a medical degree with appropriate licensure and experience in clinical medicine are essential. Familiarity with healthcare management systems, medical auditing tools, and utilization review protocols are typically required. Strong analytical thinking, decision-making, and interpersonal communication skills help HMO Medical Officers navigate complex cases and work collaboratively with providers and administrative teams. These competencies are vital for ensuring high-quality, cost-effective patient care and compliance with organizational standards.

More about Hmo jobs
What are the most commonly searched types of Hmo jobs? The most popular types of Hmo jobs are:
What states have the most Hmo jobs? States with the most job openings for Hmo jobs include:
What job categories do people searching Hmo jobs look for? The top searched job categories for Hmo jobs are:
Hmo jobs near you
Infographic showing various Hmo job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 87% Full Time, 10% Part Time, and 2% Contract. Highlights an 92% Physical, 3% Hybrid, and 5% Remote job distribution.

Senior Analytics Consultant - HMO & Quality Analytics - Work From Home

Health Care Service Corporation

Tulsa, OK • On-site, Remote

$84K - $152K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 10 days ago

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job SummaryThe Senior Analytics Consultant's primary responsibility is to leverage strong Tableau skills and healthcare industry knowledge to support clinical and business stakeholders for the IL Commercial HMO and Marketplace. This role will be accountable for the overseeing NCQA analytical support and consultancy of internal/external customers and advisory service for internal/external senior leaders. The individual in this role will use their healthcare industry knowledge to report and review data in Excel, SQL, Python and R. The individual will primarily use their storytelling skills leveraging Tableau and Power BI to display outcomes and opportunities.
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Required Job Qualifications:

  • Bachelor's degree and 6 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR Master's degree with 4 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR PhD with 2 years of experience in health care services, statistical analysis, or insurance industry economics or related field OR 10 years of experience in health care services, statistical analysis, or insurance industry economics or related field

  • Understanding, and being highly proficient at querying a wide variety of internal and external data sources to get meaningful insights.

  • Strong analytical skills and proficiency in computer languages, such as SQL, Python, R, etc.

  • Ability to create a dynamic and visually engaging dashboard leveraging data visualization tools such as Tableau or Power BI

  • High degree of business intelligence and understanding how to take a business case from inception to customer or partner execution.

  • Experience leading an analytic initiative to success.

  • Excellent communication and presentation skills.

  • Ability to work independently and as part of a team.

  • Performance excellence in championing initiatives and collaborating with multiple stakeholders to bring the initiative to life.

  • Ability to work under pressure and delivery high quality output to senior leadership to decision making within short timeline.

Preferred Job Qualifications:

  • Expert Level Tableau User: ability to develop dashboards from scratch within the tool.

  • Experience with project management methodologies.

  • Experience of Healthcare industry - payor, provider, pharmacy, public health, epidemiology, etc.

  • Experience with version control/collaborative tools, such as GitHub

  • Experience with automation tools, such as Alteryx.

  • Work From Home:This position is fully remote and available in the US only.

  • Sponsorship: Sponsorship is not available.

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement:

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards.

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plansubject to the terms and the conditions of the plan.

HCSC Employment Statement:

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range$84,400.00 - $152,300.00

Exact compensation may vary based on skills, experience, and location.

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