Healthcare Provider Management Executive (Medical Operations) at Fosad Consulting

Key Responsibilities And Accountabilities
 

• Sign up of providers across the country
• Provider selection and management: enlisting, negotiation, delisting, rewarding, training, enlightening
• Tariff negotiation and review
• International Providers selection and management
• Scheduling major and highly specialized patient procedure
• Utilization Review Management (total review of all enrollees that receive care within the period)
• Case Management – concurrent and post management review with managing physicians
• Providers audit and quality assurance: this involves infrastructure audit, treatment protocol compliance, service quality
• Care review for admitted and complex cases in secondary and tertiary care
• Review of care delivery protocols
• Analysis of hospitals tiers and capability
   

Required Competencies
 

• Knowledge of the function
• Knowledge of the Business
• Analysis and development of solutions
• Decision-making autonomy

Requirements

• Bachelor of Medicine, Bachelor of Surgery (MBBS)
• At least 3 years of Experience working as in provider management in a Healthcare Maintenance Organization
• An MBA would be an added advantage