The role is responsible for planning, and coordinating operational activities for the organization. Providing support to the team and helping business in achieving success from the same.
Dimensions
Positive knowledge on MS Office and Excel.
Key Challenges for the role
Knowledge of DRM processes
Stay abreast with current processes / suggest improvements
Understanding of DRM systems (process flow System fields)
TAT expectations management for specialized business handling
Coordinate with other departments, team members and management to ensure smooth information flow to ensure that operations are carried out, recurring issues are resolved
Create/maintain standards/protocols for DRM team
Maintain a consistent service delivery to ensure client retention and satisfaction
Identify risks to the company and escalate accordingly
Execution of processes operations, to be in line with defined standards
Inputs for refinement and development of guidelines and procedures
Publishing raised claims with Claims Team and sharing a positive feedback
Ensure timely and accurate updation of various documents/reports in compliance with the SOP
Key Result Areas
Supporting Actions
Management of customers with diseases delivering as per internal medical protocols
Manage high disease risk customers/patients over the phone/emails/EMR and, if required, in person
Should understand the medical diseases and finer details of their management protocol along with the finer details of the program construct
Follow/Develop a detailed plan of tracking as per the protocol keeping in mind the complications that could arise
Coordinate with external customers/patients based on the risk trigger ensuring maximum level of sensitivity and confidentiality while managing cases
Managing all cases on a case to case basis ensuring that majority customers/patients are adhering to the program construct
Manage changes and escalations effectively on a case to case basis
Measure program performance with relevant reports and at defined frequency
Report and escalate to management as and when needed
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📌 Am/dm Health Management Mumbai
🏢 Aditya Birla Insulators
📍 Mumbai
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