Casemix Manager

Siloam Hospitals Group (Tbk); Jakarta Selatan; On-site; IDR 100.000.000 - 200.000.000; Full time

Job summary

A leading healthcare provider in Jakarta Selatan is seeking a Quality Manager to oversee service quality and operational initiatives. The role requires a Bachelor Degree in a related field and at least 2 years of experience in medical quality management. Key responsibilities include managing patient care quality, collaborating with hospital leadership, and conducting financial performance analysis. Join us to lead quality healthcare transformation.

Qualifications

• Minimum 2 years work experience in health or quality management.
• Experience in quality projects or internal audit is a plus.
• Familiarity with ICD, DRG, and healthcare classification systems.

Responsibilities

• Manage quality and costs of patient services and care.
• Collaborate with hospital leaders on strategic and operational planning.
• Analyze discrepancies between billing rates and insurance reimbursements.

Skills

Problem-solving skills

Attention to detail

Proficiency with coding systems

Education

Bachelor Degree in Medical Department or related field

Job description

Located in the business district of South Jakarta, Siloam Hospitals Simatupang has become a trusted private hospital for locals and foreigners living in the South Jakarta area. The hospital provides all kinds of quality healthcare services, especially through its excellent services in cardiology, neurosciences, orthopaedics and radiation oncology. With modern medical equipment and tools, the specialists, general practitioners, nurses, and support staff at Siloam Hospitals Simatupang are committed to providing patients with international-standard healthcare and services.

Job Description

• Manage the quality and costs of services/care provided to patients and be responsible for carrying out various initiatives, both strategic and operational, including analyzing patients by each service unit, ensuring positive internal referrals, and building good relationships between units and related external parties
• Collaborate with hospital leaders (CEO, Hospital Director, AMA) in areas ranging from strategic planning to operational development
• Collaborating with Finance to conduct an analysis of gross margins based on type of service (craft groups) and treatment
• Analyze discrepancies between hospital billing rates and insurance reimbursements to identify opportunities for improved financial performance in insured patient cases.
• Collaborating with the Siloam marketing and clinic team.
• Hold regular meetings with Siloam clinics, non-Siloam clinics and other related hospitals to get priority referrals.
• Collaborate with AMA to improve performance of low utilization equipment.
• Review and carry out daily supervision of insured inpatients based on daily reports from the RMO for IPD cases
• Maintaining the estimated number of claims in the web application and communicating it with specialist doctors.
• Conduct discussions with AMA and/or Hospital Director regarding difficult or special cases.
• Communicate with the medical team (specialists and RMO) and pharmacy to review the services, procedures, and examinations provided to insured patients, starting from the reception of IPD patients and/or based on daily reports until discharge, including any follow-up examinations..
• Ensure that the rooms provided are in accordance with the specified patient class and/or patient top-up standards (if any).

Qualifications

• Bachelor Degree from any related major (preferably in Medical Department)
• Have minimum 2 years work experience in the field of health or quality management, having experience in quality projects or internal audit will be plus
• High attention to detail to ensure accuracy in coding and data reporting.
• Strong problem-solving skills to address and resolve issues related to case mix data and coding practices.
• roficiency with coding systems such as ICD, DRG, and other classification systems used in healthcare.

Additional Information

[BEWARE OF RECRUITMENT SCAMS]

It has come to our attention that there are fake job offers claiming to be hiring for Siloam Hospitals Group. Please note that Siloam Hospitals Group do not require applicants to make payment when seeking employment with our hospitals.

Healthcare & Medical More than 10,000 employees

Siloam Hospital Group (SHG) is Indonesia's top leading hospital chain with 41 hospital units across the nation. Providing progressive and innovative healthcare services since 1996, Siloam was established in a mission to increase equitable access to affordable, quality healthcare across Indonesia.

The Group's vision of International Quality, Reach, Scale, and Godly Compassion continues to set the platform for Siloam to respond to the dynamic social transformation in Indonesia, while at the same time developing a business strategy that allows our hospitals to operate at a lower cost on economies of scale and enhance affordability in the nation's medical care demands.

Siloam continually seeks out motivated and professional leaders to join our team!

Join us as we make way to push boundaries and pioneer into the era of innovation, transformation, and digitalization!

The Skill to Pioneer. The Spirit to Care.

Find us on:

PT Siloam International Hospitals Tbk (Head Office)

LinkedIn: Siloam Hospitals Group