Casemix Manager
Core
Manage quality and costs of services for BPJS patients, analyze case mix data, and optimize hospital operations and referrals.
Role type
Senior Casemix Manager
Builds
Operational efficiency and profitability for BPJS patient services
Domain
Healthcare administration / Health insurance (BPJS)
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Case mix analysis, BPJS reimbursement analysis, gross margin analysis, ICD/DRG coding, ALOS management, stakeholder collaboration, data reporting accuracy, problem-solving
Preferred skills
Quality project experience, internal audit experience
Technologies
ICD, DRG, web applications
Responsibilities
Analyze BPJS patients by service unit, collaborate with hospital leaders on strategic planning, monitor billing vs reimbursement differences, manage average length of stay, supervise daily reports for IPD cases, maintain claim estimates in web applications, build hospital networks
Seniority
Mid-level, hands-on operational management