Healthcare Decision Analyst

6 days ago


Pasig, National Capital Region, Philippines Hive Health Full time
Key Responsibilities
  • Provide clinical guidance to complex cases to facilitate approvals of medical availments.
  • Review, adjudicate, and approve cases related to inpatient discharges, ensuring accurate coverage decisions and smooth patient transitions.
  • Take the lead in providing critical weekend and after-hours support, ensuring urgent cases are managed promptly and healthcare services remain uninterrupted.
  • Evaluate member utilization by analyzing claims data, categorizing cases by illness, and determining remaining coverage limits to ensure proper benefit allocation.

If you possess a graduate degree in medicine, at least 3 years of relevant clinical experience, and excellent problem-solving skills, we encourage you to apply for this challenging and rewarding role.



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