Health Management Analyst

4 days ago


Taguig, National Capital Region, Philippines Cobden & Carter International Full time

This role supports US Health and Benefits Consultants by analyzing data, producing reports, and managing projects. It involves conducting gap analysis, ensuring compliance, and handling internal and vendor communications. Attention to detail and proficiency in Microsoft Office are required.

Responsibilities

  • Manage NQTL assessments: Oversee the Non-Quantitative Treatment Limits (NQTL) portion of parity assessments, attending team meetings.
  • Prepare data requests: Review client-facing vendor documents (e.g., summary plans, benefits) and monitor responses from carriers and vendors.
  • Review carrier responses: Analyze data from carriers, determine recommendations for parity issues, and collaborate with team members to ensure accurate language and findings.
  • Coordinate with project manager: Manage timelines, status, follow-ups, and report any issues impacting the project timeline.
  • Validate responses: Ensure completeness of data and map carrier responses to the appropriate sections of NQTL documents.
  • Collaborate for clarification: Work with senior reviewers and project managers to follow up with carriers/vendors for clarification or additional documents.
  • Contribute to report completion: Support the NQTL section of the report and assist in project completion.
  • Organize meetings: Schedule and coordinate team efforts to ensure timely delivery of tasks.
  • Participate in status calls: Engage in regular project status calls (weekly/bi-weekly) to track progress.
  • Engage in roundtables: Participate in discussions regarding Mental Health Parity and Addiction Equity Act (MHPAEA) as needed.
  • Maintain documentation: Keep materials organized and ensure proper filing and documentation throughout the project lifecycle.

Minimum Qualifications

  • College degree graduate
  • 3+ years of experience in US health and welfare plans, ideally from a benefit consulting firm, Health Plan, or insurance company.
  • Experience with US-based consulting or healthcare firms is a plus.
  • Understanding of US health plan processes such as utilization/case management, network management, credentialing, quality management, pharmacy prior-authorization, and overall health plan operations.
  • Basic understanding of Mental Health Parity regulations.
  • Proficiency in MS Office
  • Excellent oral and written communication skills in English.
  • Project and time management skills

Type, Location, Schedule, Setup

  • Direct and Full-time Employment
  • Taguig
  • Night Shift
  • Hybrid Setup (once a week onsite)
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