Casemix Manager

Responsibilities

• Manage the quality and costs of services provided to patients through strategic and operational initiatives
• Collaborate with hospital leadership (CEO, Hospital Director, AMA) on strategic planning and operational development
• Partner with Finance to analyze gross margins based on service types and treatments
• Analyze discrepancies between billing rates and insurance reimbursements to improve financial performance
• Coordinate with marketing and clinic teams to drive referrals
• Supervise insured inpatients based on daily reports from the RMO
• Maintain estimated claim numbers in web applications and communicate with specialist doctors
• Review services, procedures, and examinations with medical teams and pharmacy to ensure alignment with patient insurance

Requirements

• Bachelor's Degree in a related major, preferably in a Medical Department
• Minimum 2 years of experience in health or quality management
• Experience in quality projects or internal audit is a plus
• High attention to detail for coding and data reporting accuracy
• Strong problem-solving skills regarding case mix data and coding practices
• Proficiency with healthcare coding systems such as ICD and DRG

About the Company

Siloam Hospitals Simatupang is a trusted private hospital in South Jakarta, providing international-standard healthcare services in specialties such as cardiology, neurosciences, orthopaedics, and radiation oncology.