Senior Case Manager
NEXtCARE
Total years of experience :6 years, 3 Months
Case management and utilization review of all high cost cases of assigned providers.
Case visits and daily rounds with the treating doctors.
Discussions with treating physicians on the case progress and proposed plan of management with expected discharge plan.
Cost containment of prolong hospitalization cases as well as high cost elective procedures.
Responding and resolving all kind of queries and concerns from our clients and members.
Escorting VVIP member during their hospital visits along with assistance in managed care.
Evaluating claims from our regional providers.
Managing all kind of complex complicated cases effectively with timely decisions.
Maintaining TAT of less than one hour above 90 % .
Responding to all queries and concerns from our regional clients, members and providers and resolving them within 24 hours.
Evaluating claims in terms of validity and eligibility.
Maintaining maximum possible output on daily basis.
Meeting deadlines and showing positive results.
Taking phone calls, dealing emergency cases and making decisions on high cost complicated case.
Maintaining regional TAT more than 95 %.
Communicating with payers in relation to high cost notifications.
Training new joiners on policy wordings and to to start with managed care.
Working in team and leading in passionate way for growth and development of company.
i was responsible for performing systemic review examinations pre operative preparation and investigations and post operative care of all admitted patients in my ward.
i am working as an MEDICAL OFFICER in general surgery department.i provide an efficient care to all my patients, i prepare them pre operatively and manage them post operatively along with counselling at the time of discharge from hospital.
i also assist my consultant surgeons during major and minor surgeries.
2ND POSITION HOLDER IN SUBJECT OF COMMUNITY MEDICINE (3RD PROFF. 2010) 2ND POSITION HOLDER IN THE SUBJECTS OF GENERAL SURGERY AND PEDIATRICS (FINAL PROFF. 2011) DEBATOR OF THE YEAR 2010, 2009.