Job profile
Manage high disease risk customers/patients over the phone/emails/EMR and, if required, in person
Should understand the medical diseases and finer details of their management protocol along with the finer details of the program construct
Follow/Develop a detailed plan of tracking as per the protocol keeping in mind the complications that could arise
Coordinate with external customers/patients basis the risk trigger ensuring maximum level of sensitivity and confidentiality while managing cases
Managing all cases on a case to case basis ensuring that majority customers/patients are adhering to the program construct
Manage changes and escalations effectively on a case to case basis
Measure program performance with relevant reports and at define frequency
Report and escalate to management as and when needed
Successfully manage the relationship with all stakeholders, internal as well as external
Perform risk management to minimize risks at a customer level as well as at a portfolio level
Establish and maintain relationships with third parties/vendors
Review the processes on a timely basis
Work towards digitization at each stage
Identify opportunity for improvement basis partners feedback
Leakage management and Governance around payment, customer benefit utilization
Manage Internal & external process Audits
Adherence to all Regulatory requirements and quick adaption to regulations
Knowledge of DRM processes:
Stay abreast with new processes / suggest improvements
Understanding of DRM systems (process flow & System fields)
TAT & expectations management for specialized business handling.
Co-ordinate with other departments, team members and management to ensure smooth information flow to ensure that operations are carried out, recurring issues are resolved.
Create & maintain standards/protocols for DRM team
Maintain a consistent service delivery to ensure client retention and satisfaction
Identify risk
Experience
0 - 3 Years
No. of Openings
1
Education
MBBS
Role
Health Manager
Industry Type
Insurance / Claims
Gender
[ Male / Female ]
Job Country
India
Type of Job
Full Time
Work Location Type
Work from Office