Siloam Hospitals Group

Private hospital network and healthcare provider

Casemix Manager

Clinical Support & Patient AdministrationConfirmed live in the last 24 hours

Full-timeYogyakarta, Yogyakarta City, Special Region of Yogyakarta, IndonesiaNo salary listedIn-person

About the Job

Requirements

A bachelor's degree in medicine is required.
At least two years of work experience in healthcare or quality management is required.
Experience with quality projects or internal audits is an advantage.
Attention to detail is required to ensure accuracy in coding and data reporting.
Problem-solving skills are required to address and resolve issues related to case-mix data and coding practices.
Proficiency with coding systems such as ICD, DRG, and other healthcare classification systems is required.

Responsibilities

Manage the quality and costs of care provided to BPJS patients, including strategic and operational initiatives.
Analyze BPJS patients by service unit, ensure positive internal referrals, and build relationships between units and relevant external parties.
Collaborate with hospital leaders, including the CEO, Hospital Director, and AMA, on BPJS strategic planning and operational development.
Work with Finance to analyze gross margins for BPJS patients by service type and treatment.
Monitor differences between hospital billing rates and BPJS reimbursement amounts to identify more profitable BPJS cases.
Collaborate with the Siloam marketing and clinic teams.
Hold regular meetings with Siloam clinics, non-Siloam clinics, and other relevant hospitals to secure priority referrals.
Work with AMA to improve the performance of low-utilization equipment.
Build and expand Siloam's network in the healthcare industry.
Work with the medical team to manage the average length of stay for BPJS patients.
Review and provide daily supervision of BPJS inpatients based on daily reports from RMO.
Maintain estimated claim counts in the web application and communicate them to specialist doctors.

Desired Qualifications

Experience with quality projects or internal audits.

Job Description

•Manage the quality and costs of services/care provided to BPJS patients and be responsible for carrying out various initiatives, both strategic and operational, including analyzing BPJS 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) related to BPJS, starting from strategic planning to operational development.

•Collaborating with Finance to conduct an analysis of gross margins for BPJS patients based on type of service (craft groups) and treatment.

•Monitor the difference between hospital billing rates and BPJS reimbursement amounts to identify more profitable BPJS 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.

•Building and expanding Siloam's network in the health industry.

•Collaborate with the medical team to manage the average length of stay (“ALOS”) for BPJS patients.

•Review and carry out daily supervision for BPJS patients based on daily reports from RMO for IPD cases.

•Maintaining the estimated number of claims in the web application and communicating it with specialist doctors.

Qualifications

•Bachelor Degree from Medicine doctor

•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.

About the Company

Siloam Hospitals Group

Private hospital network and healthcare provider

Siloam Hospitals Group runs a large private healthcare network in Indonesia with 41 hospitals and many clinics across 23 provinces. It delivers inpatient and outpatient services to self-paying patients, corporate clients, insurers, and BPJS participants, generating revenue from room charges, procedures, consultations, pharmaceuticals, and diagnostics. The group focuses on high-complexity care in cardiology, oncology, neurology, neurosurgery, orthopedics, and gastroenterology, operating Centers of Excellence to coordinate advanced treatments, and uses a managed service model that lets hospitals be built with external capital while sharing revenue. Its goal is to expand access to high-quality private healthcare in Indonesia, strengthen specialized care, and maintain a broad, affordable service network for individuals, employers, insurers, and government programs, backed by JCI accreditation as a quality benchmark.

Company size: 5,001-10,000
Company stage: IPO
Headquarters: Tangerang, Indonesia
Founded: 1996

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