Regional Manager
Current1) Maintaining positive Gross Margin of the Region.2) Coordinate and Follow-up with SACHIS and ISA for handling hospital's claims queries.3) Coordinate and Follow-up with external stakeholders for timely payment of Hospitals4) Claims rejection to be controlled and should not exceed more than 10 %.5) Ensure onboarding of all empaneled Hospitals and increase daily claims transaction.6) Maintaining per PMAM claims productivity - Greater than 5 cases per PMAM per day.7) Ensure proper mapping of PMAM at all transactional locations and no empty places.8) Liaisons with Government Officials and Day to day interactions with Nodal Officers, CMOs, MoIC and other stakeholders to ensure quality service to Patients and to increase claims count.9) Keeping track of all Government Letters10) Mandatory visit to 6 districts and 25 Public EHCP per month.11) Attend monthly DHS Meeting of the meeting while visit to districts and establish good relation with ASHA, ANM, CHO and other government field staff for referral cases at CHCs and District Hospitals.12) Maintaining MIS report of the region (Hospital wise, PMAM wise) on daily basis and keeping end-to-end track of all claims from Pre-auth to claims settlement.13) On time hiring and replacement of resources with help of HR Team.14) Mandatory to coordinate with public EHCP Nodal / Authority for Ayushman Kiosk and Branding across the EHCP.15) Team handling and people management. Bring innovative ideas to improve project efficiency, Also provide weekly training of PMAM on claims process and handling queries.16) Soft skills training of PMAM and District Coordinators and Mentoring team to ensure they work as per company policy and guidelines issued by NHA/ SHA17) Grievance and Escalation Management at local level and participate in EIC activity.18) Handling of More than 300 PMAM and 18 District Coordinators and maintaining their attendances and other day to operational activities.
