Hospital Inspector
Cigna Group
Hospital Inspector
Cigna Group
Sells health coverage and pharmacy benefits
Inspector/a Hospitalario/a
Ubicación: Madrid, España
Somos una compañía global de Seguros de Salud, ofreciendo una amplia gama de planes de salud y servicios, además de programas de salud y bienestar creados para cubrir las necesidades de nuestros clientes, proveedores y partners.
Buscamos incorporar un/a enfermero/a al equipo de Gestión Asistencial de la compañía, un/a Inspector/a Hospitalario/a que sea los ojos de la compañía en el hospital y la voz del hospital en la empresa.
Objetivos:
- Control del gasto médico.
- Optimizar la estancia hospitalaria.
- Revisión de facturación de hospitales.
- Mejora de la experiencia del cliente en pacientes ingresados.
Funciones:
- Control del censo y seguimiento ingresos hospitalarios.
- Revisión y control de facturación de hospitales.
- Mejora de la experiencia cliente Cigna en el uso del seguro.
- Soporte call center para asesoramiento asistencial.
- Derivación de pacientes hacia la gestión del Case Management.
- Control y gestión de gasto médico (hospitales y profesionales sanitarios).
- Control del circuito Autorización/Realización/Facturación del servicio.
- Detección de FWA (Fraud, Waste and Abuse).
- Diseño e implementación de procedimientos coste-eficientes según especialidades
- Gestión de camas hospitalarias en hospitales.
- Negociación proveedores: tarifas anuales, conciliación diferencias de facturación
- Implementación facturación electrónica proveedores
- Diseño y negociación de baremos proveedores sanitarios
¿Qué ofrecemos?
About Cigna Healthcare
Cigna Healthcare, a division of The Cigna Group, is an advocate for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Join us in driving growth and improving lives.Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
If you require reasonable accommodation in completing the online application process, please email: [email protected] for support. Do not email [email protected] for an update on your application or to provide your resume as you will not receive a response.
Sells health coverage and pharmacy benefits
The Cigna Group sells health coverage and pharmacy services to employers, health plans and individuals, and most of its business runs through Evernorth, its health services arm. Evernorth owns Express Scripts, one of the largest pharmacy benefit managers in the U.S., which negotiates drug prices and processes prescriptions for plan sponsors, plus the specialty pharmacy Accredo. Its Cigna Healthcare unit sells medical, dental and behavioral coverage, mostly to employers that fund their own plans, and earns premiums and administrative fees, while Evernorth earns service fees and drug margins. The company was formed in 1982 through the merger of Connecticut General and INA and is based in Bloomfield, Connecticut.
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