49 general medicine jobs found in Honolulu

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Sumitomo Pharma. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Sumitomo Pharma Co., Ltd., is a global pharmaceutical company based in Japan with operations in the U.S. (Sumitomo Pharma America, Inc.), focused on addressing patient needs in oncology, urology, women's health, rare diseases, cell & gene therapies and CNS. With several marketed products and a diverse pipeline of early- to late-stage investigational assets, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more...

We anticipate the application window for this opening will close on - 23 Feb 2026 At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You'll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world. A Day in the Life We are seeking a committed professional to join our team. While this is a remote position not located at a physical Medtronic site, the candidate hired will be required to reside within the territory and drive to multiple accounts throughout the region. A valid driver's license is essential for this role. Join Medtronic as an Affera Mapping Specialist and be at the forefront of transforming lives through advanced medical technology! In this dynamic role, you'll work alongside a collaborative team of clinicians, engineers, physicians, and innovators to execute mapping solutions for cardiac and other electrophysiological systems. By...

We anticipate the application window for this opening will close on - 23 Feb 2026 At Medtronic you can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You'll lead with purpose, breaking down barriers to innovation in a more connected, compassionate world. A Day in the Life We are seeking a committed professional to join our team. While this is a remote position not located at a physical Medtronic site, the candidate hired will be required to reside within the territory and drive to multiple accounts throughout the region. A valid driver's license is essential for this role. Join Medtronic as an Affera Mapping Specialist and be at the forefront of transforming lives through advanced medical technology! In this dynamic role, you'll work alongside a collaborative team of clinicians, engineers, physicians, and innovators to execute mapping solutions for cardiac and other electrophysiological systems. By...

Company : Highmark Health Job Description : JOB SUMMARY This role delivers high-impact analytics and insights focused on Social Determinants of Health (SDOH) to support enterprise strategy and population health initiatives. The position contributes to the development and evolution of enterprise SDOH dashboards and self-service analytic tools, with a focus on analytical rigor, scalability, and alignment to high-value use cases. The incumbent serves as a consultative analytic partner to the Enterprise SDOH team, collaborating to refine analytic questions and translate complex needs into clear, actionable analytic approaches. As reporting capabilities mature, this role will support advanced analysis of varied and multilevel data in exploratory, evaluative, and research-adjacent analytic work, and development of insights that inform program design and strategic decision-making. ESSENTIAL RESPONSIBILITIES Supports and leads the design, development, execution,...

Company : Highmark Inc. Job Description : JOB SUMMARY This role supports the Medical Policy team by bringing medical director level expertise, experience and knowledge to the team. They support the full-cycle ownership of commercial and Medicare Advantage medical policies, both developed internally and by vendors. This includes the writing of clinical criteria based on research, engagement of clinical and non-clinical team members for operational guidelines. The incumbent must have an understanding of medical coding (ICD-10, CPT, HCPS) as medical coding based off policy criteria falls within their scope. In addition to developing new policies, the incumbent ensures all existing medical policies, in their scope, are in accordance with NCQA and/or CMS requirements. The incumbent may be required to address escalated inquiries brought forward by internal/external partners. Conducts peer reviews as part of the quality review process. In addition to policy ownership, the...

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Sumitomo Pharma. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Sumitomo Pharma Co., Ltd., is a global pharmaceutical company based in Japan with operations in the U.S. (Sumitomo Pharma America, Inc.), focused on addressing patient needs in oncology, urology, women's health, rare diseases, cell & gene therapies and CNS. With several marketed products and a diverse pipeline of early- to late-stage investigational assets, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more...

Job Summary Within Otsuka Pharmaceutical Co. exists Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC) a U.S.A. subsidiary exists the Global Clinical Development (GCD) department. OPDC-GCD are a group of physicians and scientists who lead clinical development activities for Otsuka's global health-care products. The Global Clinical Development Program Leader is responsible for leading the end-to-end strategy, and development and delivery of a portfolio of novel serotonergic agonists (NSA). Shaping and executing late-stage clinical development strategies for the NSA portfolio of therapeutic assets, ensuring programs progress efficiently toward registration and commercialization. This role serves as the primary and single point of contact for internal and external stakeholders, ensuring seamless integration, governance, and lifecycle management from early-stage development through submission to global health authorities. This role provides scientific,...

Become a part of our caring community and help us put health first The Senior Business Intelligence Engineer utilizes advanced tools, technologies, and best practices to transform raw data into insightful and actionable business intelligence. This position works collaboratively with stakeholders to gather and understand business requirements, ensuring data integrity, accuracy, and consistency across all deliverables. The ideal candidate will demonstrate independent judgment in addressing moderately complex to complex technical challenges, with significant latitude to establish objectives and determine approaches to assignments. Success in this role requires strong analytical skills, a commitment to data quality, and the ability to communicate effectively with technical and non-technical audiences. The Senior Business Intelligence Engineer responsibilities will be to: Design, develop, and maintain business intelligence solutions, including dashboards, reports, and...

Become a part of our caring community and help us put health first The Principal Product Manager Conceives of, develops, delivers, and manages products for customer use. The Principal Product Manager provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. A high-performing, independent role dedicated to tackling cross-team, cross-functional technology and analytics problems in with a focus on innovation, action, and speed-to-market. Primary focus will be on ensuring complete and accurate diagnosis and follow up for our members. This role will work with 2-5 developers within our team on high-profile projects. Responsibilities will include partnering with the business, gathering requirements, developing project plan including resource needs, supervising project execution, hands-on development and analysis as appropriate, customer feedback loop, executive presentation. Critical skills include independent project...

Become a part of our caring community and help us put health first The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting medical necessity and comprehensive medication reviews for prescriptions requiring prior authorization. This role involves evaluating complex clinical scenarios and applying evidence-based criteria to ensure appropriate medication use. The pharmacist addresses moderately complex to complex issues that require critical thinking and in-depth analysis of variable factors. Earn a $5,000 hiring bonus! Bonus is paid after 180 days of employment; you must be employed until that date to be eligible to receive the payment." Location: Remote - United States Schedule: 8-hour shifts, Monday through Friday, between 10:30 AM and 11:00 PM EST OR 10-hour shifts, Tuesday through Friday, between 10:30 AM and 11:00 PM EST Required to work every 5th Saturday Required to work 1 company holiday...

Become a part of our caring community and help us put health first The Principal Solutions Architect works with user groups to solve business problems with available technology including hardware, software, databases, and peripherals. The Principal Solutions Architect provides strategic advice and guidance to functional team(s). Highly skilled with broad, advanced technical experience. Discover how your passion can make a difference at Humana. Apply today and embark on your career journey with a company recognized as one of the Best Places to Work and named among Forbes America's Best Employers for Tech Workers. Role Overview We are seeking a Principal Solutions Architect to serve as the chief architect for our enterprise Next Best Action (NBA) platform. This position is responsible for defining and/or overseeing the end-to-end architecture, from domain modeling and data ingestion to decisioning, orchestration, and omnichannel activation. The role provides technical...

Become a part of our caring community and help us put health first The Supervisor, Outbound Sales Support leads the team who conducts selling activities related to outbound calls within a primary care setting. Assists the team with strategies to re-engage and/or drive retention of customers. The Supervisor, Outbound Sales Support works within thorough, prescribed guidelines and procedures; uses independent judgment requiring analysis of variable factors to solve basic problems; collaborates with management and top professionals/specialists in selection of methods, techniques, and analytical approach. Job Functions: Leads the team responsible for winning back and re-engaging Medicare eligible patients through telephonic conversations. Guides proactive determination of patients' needs in order to provide stellar customer service leading to re-engaging former patients. Ensures team effectively describes services offered and sells prospective patients on the...

Become a part of our caring community and help us put health first The Policy Governance Professional 2 policy Governance is the combination of Compliance processes established and executed that are reflected in the organization's structure and how it is managed and led toward achieving goals. The Policy Governance Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. The Policy Governance Professional 2 supports the ongoing development, review, and management of Utilization Management (UM) policies and procedures. This role works closely with UM governance and relevant committees, ensuring documentation and reporting align with regulatory standards and organizational objectives. The position also assists with monitoring and reporting quality metrics, and is responsible for preparing clear, accurate written materials to support compliance and continuous improvement initiatives....

Become a part of our caring community and help us put health first The Policy Governance Lead is the combination of Compliance processes established and executed that are reflected in the organization's structure and how it is managed and led toward achieving goals. The Policy Governance Lead works on problems of diverse scope and complexity ranging from moderate to substantial. The Policy Governance Lead for Utilization Management (UM) is responsible for overseeing the development, implementation, and management of UM policies and related quality reporting activities. Additionally, this role supports Utilization Management (UM) governance by collaborating with UM leadership and committees to ensure that UM program operations align with regulatory requirements, internal standards, and continuous improvement objectives. The Lead coordinates with relevant stakeholders to facilitate policy review, compliance monitoring, quality reporting, and effective communication of program...

Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. Humana's MarketPoint organization is looking for 5 Customer Success Agents who are bilingual in English and Spanish to join the Customer Success Team working remote. Humana's Customer Success Agents are our members' trusted partners in navigating healthcare. In this role, you'll provide guidance and solutions to ensure a positive member experience, from explaining plan benefits to resolving issues...

Become a part of our caring community and help us put health first With over 10 million sales interactions annually, Humana understands that while great products are important, it's the quality of our service that truly defines us. We know that when our members and prospects have delightful and memorable experiences, it strengthens their connection with us and enables us to put their Health First. After all, a health services company that has multiple ways to improve the lives of its customers is uniquely positioned to put those customers at the center of everything it does. Humana's MarketPoint organization is looking for 10 Customer Success Agents to join the Customer Success Team working remote. Humana's Customer Success Agents are our members' trusted partners in navigating healthcare. In this role, you'll provide guidance and solutions to ensure a positive member experience, from explaining plan benefits to resolving issues around disenrollment or dual eligibility....

Become a part of our caring community and help us put health first The Risk Management Professional 2 identifies and analyzes potential sources of loss to minimize risk. The Risk Management Professional 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines and procedures. As a Risk Management Professional 2 - HCPR Compliance, you will work with HCPR Operations to ensure operational processes are complaint with appropriate regulations and report data that accurately reflects operations. In this role you will: In this role you will: Develop data universe generation guidelines (DUGG) for audit universes by interpreting protocols/guidance and reconciling it to processes/system logic Produce monthly...

Become a part of our caring community and help us put health first The Network Operations Coordinator 4 maintains provider relations to support customer service activities through data integrity management needed for service operations. The Network Operations Coordinator 4 assumes ownership and leads advanced and highly specialized administrative/operational/customer support duties that require independent initiative and judgment. The Network Operations Coordinator 4 manages provider data for health plans including but not limited to demographics, rates, and contract intent. Manages provider audits, provider service and relations, credentialing, and contract management systems. Executes processes for intake and manage provider perceived service failures. Decisions are regarding the daily priorities for an administrative work group and/or external vendors including coordinating work activities and monitoring progress towards schedules/goals, and often oversees work of others...

At WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, while serving as a care provider and care plan to those individuals we serve. Our Health Plan Services team helps ensure excellent care delivery for our participants, and the Claims Examiner plays a pivotal role in ensuring timely and efficient processing of claims for our contracted specialty provider partners. Essential Job Duties: Assess appropriateness of returned, denied, or paid claims by reviewing and following contractual obligations, federal and state regulations, organizational policies and procedures, or other established quality standards Work alongside manager to establish and maintain claims processing rules that meet all regulatory and business requirements Assist internal and external partners with questions related to claims decisions or claims statuses Job Requirements:...

Become a part of our caring community and help us put health first At Humana, we are focused on the elimination of unjust, avoidable and unnecessary barriers in health and health care. The Data Manager 2 (DM2), reporting to the Health Equity Strategy Lead, supports the whole-person, integrated care model for members in our Medicaid and Medicare market to help build the toolkit for equitable population health. In particular, we partner with executives, managers and other leads to advance Care Management, Quality Improvement, Community Engagement, Marketing, Health Economics and Finance to bring a greater understanding of factors that apply to wellbeing from a view of physical, behavioral and spiritual health. The Data Manager 2 supports all aspects of configuration control, data management, and deficiency reporting. The Data Manager 2 work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action....

Become a part of our caring community and help us put health first The Help Desk Support Technician 2 provides support to end users for computer, application, system, device, access and hardware issues. Utilize technical experience and customer service skill to assist end users to resolve incidents and fulfil requests remotely and escalate as needed. Involvement in project planning; installing, configuring, upgrading, and troubleshooting of computer-related hardware and software components, responding to and resolving customer requests; team leadership to ensure customer support expectations are addressed in accordance with policy, meeting service level requirements and providing excellent customer service. The Help Desk Support Technician 2: Identifies, researches, and resolves technical problems of moderate complexity. Responds to telephone, email and online requests for technical support. Documents, tracks, and monitors the problem using applicable...

Become a part of our caring community and help us put health first The Customer Success Manager is a key leadership role responsible for ensuring customer retention through proactive engagement, strategic initiatives, and operational excellence. This role works collaboratively to ensure alignment and consistent performance, managing up to 25 Customer Success Agents to deliver on retention objectives and test new business initiatives. The Customer Success Manager plays a critical role in driving customer retention through proactive engagement with customers and the implementation of strategic retention initiatives. In addition to core retention campaigns and allegation mitigation, the role supports Call Quality for their team, contributes to broader enterprise value by test & learning new initiatives, and can be part of building something from the ground up. The Customer Success Manager should be ready to receive objectives and determine approach, resources, goals, and...

Become a part of our caring community and help us put health first Humana Healthy Horizons is hiring a Compliance Professional who will support efforts for overall Medicaid business by joining the team overseeing the facilitation of Policy Governance. The Policy Governance team coordinates ad hoc as well as annual updates to all Medicaid policies across business units and across states. This core function is crucial to Humana ensuring that all Medicaid policies are accurate, up-to-date and reviewed annually, at a minimum. This is a fully remote, work from home position. The Policy Governance Compliance Professional works to ensure accurate and updated policy content for Medicaid. The Compliance Professional will work collaboratively with business partners to facilitate policy updates throughout the year as well as during annual review. This position requires strong technical skills to leverage the designated system for policy maintenance, as well as strong relationship...

Sumitomo Pharma Co., Ltd., is a global pharmaceutical company based in Japan with operations in the U.S. (Sumitomo Pharma America, Inc.), focused on addressing patient needs in oncology, urology, women's health, rare diseases, cell & gene therapies and CNS. With several marketed products and a diverse pipeline of early- to late-stage investigational assets, we aim to accelerate discovery, research, and development to bring novel therapies to patients sooner. For more information on SMPA, visit our website https://www.us.sumitomo-pharma.com or follow us on LinkedIn. Job Duties and Responsibilities Support development of communications with Senior Executives and strategic partners to report analytical findings and key performance metrics Develop models to set pricing strategy with the goal of supporting attainment of coverage goals and maximizing net revenue Develop payer & provider deal models to assess the implications of deal scenarios on...