BPJS Case-Mix & Revenue Manager

Siloam Hospitals Group; Tangerang; Híbrido; IDR 240.000.000 - 480.000.000; Jornada completa

Descripción de la vacante

Siloam Hospitals Group in Indonesia seeks a BPJS Quality & Financial Analyst to manage BPJS services, ensuring quality and cost efficiency across units. You will collaborate from strategic planning to operational development with hospital leaders and AMA.

Responsibilities include analyzing BPJS patients by service, monitoring billing vs reimbursement, and maintaining data accuracy while expanding the BPJS network and ensuring regulatory compliance.

Formación

• Bachelor Degree from any related major (preferably in Medical Department).
• Minimum 2 years work experience in health or quality management; quality projects or internal audit is a plus.
• High attention to detail to ensure accuracy in coding and data reporting.
• Strong problem-solving to address and resolve issues related to case mix data and coding practices.
• Proficiency with coding systems such as ICD, DRG, and other classification systems used in healthcare.

Responsabilidades

• Manage BPJS service quality and costs across units and analyze BPJS patients by service.
• Collaborate with hospital leaders (CEO, Hospital Director, AMA) from strategic planning to operational development.
• Analyze gross margins for BPJS patients by service type and treatment.
• Monitor the difference between hospital billing rates and BPJS reimbursement amounts to identify more profitable BPJS cases.
• Collaborate with AMA, Finance, Marketing, and clinics to improve referrals.
• Hold regular meetings with Siloam clinics, non-Siloam clinics and other related hospitals for priority referrals.
• Collaborate with AMA and Hospital Director to improve performance of low utilization equipment.
• Build and expand Siloam's network in the health industry.

Conocimientos

Quality management

Attention to detail

Problem solving

ICD/DRG coding

Educación

Bachelor degree in medical/related

Descripción del empleo

Siloam Hospitals Group in Indonesia seeks a BPJS Quality & Financial Analyst to manage BPJS services, ensuring quality and cost efficiency across units. You will collaborate from strategic planning to operational development with hospital leaders and AMA.

Responsibilities include analyzing BPJS patients by service, monitoring billing vs reimbursement, and maintaining data accuracy while expanding the BPJS network and ensuring regulatory compliance.