Medical Coordinator & RMO

Role & responsibilities

1 He/She will ensure that all required evaluation including diagnostic tests are done free of cost for all beneficiaries and the details of the same along with reports are captured in the Society portal.

2. He/She will upload the OP/IP status of the patient.

3. He/She will guide the patient in all aspects and sign the investigation request.

4. He/She has to cross check whether diagnosis is covered in the scheme. If doubtful about the plan of management, then should coordinate with treating specialist along with Package list as specified in the MJPJAY / PMJAY Manual on Surgical & Medical Treatments for Cashless Treatment of BPL Population.

5. He/She should facilitate the admission process of Patient without any delay.

6. After admission He/She will collect all the necessary investigation reports before sending or approval.

7. He/She will upload the admission notes and preoperative clinical notes of the patient.

8. He/She will ensure that preauthorisation request is sent only for those who are on bed (IP).

9. He/She will ensure before sending Preauthorization that all documents like ration/health card, Patient photo and also necessary reports like CT Films, X-Ray films, Biopsy etc. are uploaded in the system.

10. He/She will coordinate with insurance and a society doctor as need arises.

11. Pre-auth kept pending from Insurance and society will be verified on a regular basis and necessary corrections to be done by MCO.

12. He/She will furnish daily clinical notes (Pre-operative and Post-operative).

13. He/She will upload 3 Photographs of the Patient taken preoperative bedside, immediate post-operative showing operation wound and at the time of discharge.

14. On Letter Head of Hospital requesting for Empanelment in pre printed stationary supplied.

15. He/She will ensure free follow up consultations, routine investigations and distribution of drugs to be supplied by the Society to the beneficiaries.

16. He/She should attend to the grievances/complaints of the MJPJAY Beneficiaries and Coordinate with the society if necessary to redresses it within 6 hrs (TAT) through ONLINE MODULE. Further he will counsel the patient accordingly.

Preferred candidate profile

Minimum Qualification- BHMS/BDS/BAMS with 4+ years of clinical experience.