Medical Officer , Doctor jobs

Responsibilities :

• The job of Case Manager involves supervision of Hospital Claims through Customer Service Officers.
• Each Case manager supervises three CSOs and on average 50 panel hospitals. The CSOs are usually experienced paramedics or have experience of working in administrative capacity in a hospital. CSOs visit panel hospitals and fill PPR on daily basis.
• The Case Manager is responsible for his/her team’s performance and to ensure that the proper gatekeeping is in place in the panel hospitals assigned. Following are the daily activities of a Case Manager to achieve this objective:
• The Case Manager ensures that the CSOs are visiting panel hospitals daily and filling PPRs with quality information and in real time. Relevant system screens and reports are available to facilitate Case Manager.
• Based on the information entered in the PPR report, the Case Manager monitors hospital admissions with a keen eye to prevent unnecessary or prolonged admissions. Timely intervention by the Case Manager is critical for plugging leakages in this area which encompasses admissions at hospitals under vigilance or admissions where length of stay is three days or more and cases highlighted by the CSO himself or through relevant reports.
• The Case Manager conducts surprise visits to network hospitals under vigilance at least once in 15 days. To the rest of the hospitals the visit is once in three months. All visits are documented, and records are maintained by the Case Manager.

Pay: From Rs95,000.00 per hour

Work Location: In person