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 customer’s/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 partner’s 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