Health Management Data Analyst (Night Shift)
Intro Recruitment Asia
Date: 1 week ago
City: Taguig
Contract type: Full time
Role
Manage NQTL operational data portion of parity assessment, including:
Manage NQTL operational data portion of parity assessment, including:
- Prepare NQTL carrier operational data requests on behalf of each client/carrier
- Coordinate with Project Manager regarding sending requests, timing, status, and follow-up
- Attend internal and client kick off meeting with QTL/NQTL team
- Monitor carrier and vendor responsiveness to data requests
- Validate completeness of response and report any issues or impact to timeline proactively to Project Manager
- Complete initial review of carrier responses for parity projects
- Map carrier responses to appropriate section of NQTL document
- Cite specific reference, criteria, and example(s) for each response
- Draft gap analysis based on documents reviewed including master templates and client specific responses
- 2-5 years' experience dealing with health and welfare plans, ideally gained in a benefit consulting/brokerage firm, Health Plan, Third Party Administrator, Regulatory Agency, Legal/Compliance Firm, or insurance company
- US Registered Nurse or LCSW with active licensed preferred
- Health analytics experience preferred
- Understanding of health plan utilization/case management processes, network management, credentialing, quality management, pharmacy prior-authorization processes and health plan operations
- Basic understanding of Mental Health Parity and Mental Health Parity Non-Qualitative Treatment Limits
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Product Supply Manager - Supply Network Operations
Procter & Gamble,
Taguig
9 hours ago
Job LocationTaguig CityJob DescriptionAre you ready to unleash your technical creativity? Innovation is the driving force behind everything we do at P&G! Across the world, you will find thousands of scientists, engineers and developers working in manufacturing plants, innovation centers and distribution facilities.Your TeamYou will be working as Product Supply manager and will be assigned in one of different disciplines...
Logistics Specialist
Manpower (Philippines),
Taguig
11 hours ago
LOGISTICS SPECIALISTInbound Shipment MonitoringEncoding of Prior Disclosure Program (PDP) Application as regular report requirement of Finance for compliance purposes related to proper declaration of duties and taxes of imported goods.Perform regular data entry tasks, including updating information, creating new records and deletion of obsolete data.Accurate encoding of importation logbook based on the inbound shipment documents provided by 3rd party brokerage...
SAP Basis Administrator
Accenture in the Philippines,
Taguig
2 days ago
Design, build and configure applications to meet business process and application requirements.Summary: As an Application Developer, you will be responsible for designing, building, and configuring applications to meet business process and application requirements. Your typical day will involve working with SAP Basis Administration, ensuring the smooth functioning of SAP systems and resolving any technical issues that may arise. Roles &...
