utilization analyst

2 weeks ago

Pasig, National Capital Region, Philippines Value Care Health Systems, Inc Full time ₱900,000 - ₱1,200,000 per year

Be part of our growing TEAM

We are looking for goal-oriented individuals to fill in the Utilization Analyst role.

The Data Analyst for Utilization Reporting is responsible for collecting, analyzing, and interpreting healthcare utilization data to support decision-making, improve care delivery, and optimize the use of health services in alignment with the HMO's strategic goals. This role collaborates with medical and account management team.

Duties and Responsibilities

  • Develop and maintain utilization reports (e.g., inpatient, outpatient, ER visits, financial assistance, reimbursement etc.) for internal and external stakeholders.
  • Analyze claims and encounter data to identify trends, patterns, and anomalies in healthcare service usage.
  • Support medical management and care coordination by identifying high-utilization of members.
  • Prepare monthly, quarterly, and ad hoc reports to monitor performance of accounts.
  • Collaborate with IT and sales teams to meet the account's special report requests.
  • Provide data-driven insights to support contract negotiations.
  • Ensure data accuracy, completeness.
  • Conduct root cause analysis on cost drivers and utilization spikes.

Qualifications:

  • Bachelor's degree in Medical field, Data Science, or a related field.
  • 2+ years of experience in data analytics, preferably in a healthcare or HMO environment.
  • Proficiency in Excel, and data visualization tools.
  • Strong analytical, problem-solving, and communication skills.
  • Willing to work in Pasig City, Mondays to Fridays, 8:00-5:00PM

VALUCARE provides our employees with a total rewards package, which includes competitive market benefits:

  • Guaranteed leave benefits on your first day
  • Guaranteed HMO on your first day
  • Performance based bonus
  • Life Insurance Coverage
  • Health care benefit coverage up to 3 dependents
  • Retirement benefits
  • Annual Salary Increase
  • Birthday Leave
  • Profit Sharing
  • Uniform Benefit
  • Medicine Allowance
  • Vitamins Allowance

In VALUCARE, we promote an environment that allows everyone to be at their best and explore their creativity.

Job Type: Full-time

Work Location: In person

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