1. ORGANIZATIONAL STRUCTURE:
1.1 REPORT TO: Hospital Administrator
1.2 RESPONSIBLE FOR: Case management, Cost Interventions and outcomes, Timely discharge
1.3 LIAISES WITH: Colleagues and HODs
Nurses
Physicians and specialist
Patients and Families
Others as related to the evaluation and care of patients
2. JOB SUMMARY:
Rejection analysis, management and coordination with responsible departments in developing collaborative strategies and promote quality and cost-effective interventions and outcomes.
3. DUTIES AND RESPONSIBILITIES:
3.1 Promote quality and cost-effective interventions and outcomes
3.2 Record cases information, complete accurately all necessary forms and produce statistical reports
3.3 Develop effective working relations and provide feedback to administrative, medical, and RCM team throughout the entire case management process
3.4 Handling case assignments, draft service plans, review case progress and determine case closures
3.5 Evaluating healthcare treatments and negotiating the most cost effective options available to manage DRG
3.6 Assist in timely discharge
3.7 Evaluate the rigor of documentation and code assignment (during IP stay with doctors) to ensure fair remuneration
3.8 Evaluate and develop training sections to avoid rejections
3.9 Rejection analysis, management and coordination with responsible departments in developing collaborative strategies.
3.10 Audit files and alert vulnerabilities with concerned departments.
3.11 All other duties and responsibilities assigned by hospital administrator.
3.12 Comply with all OSH (Occupational safety and health )and infection control policies, standards and procedures and cooperate with hospital management to comply those requirements
3.13 Work accordance with the documented OSH procedures and instructions, specific responsibilities
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