State Anti Fraud Unit (SAFU) Manager

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About the Organization

Ayushman Bharat-PMJAY-provides a cover of Rs 5 lakhs per family per year for sec. & tertiary care. Over 1.21 crore poor & vulnerable entitled families ( = 5.5 crore beneficiaries approx. ) PMJAY will reduce hospital expenditures due to which 6 crore people are pushed to poverty. Improve affordability, accessibility & quality of care Worlds largest fully government-financed health insurance scheme.

Job Description

To play a key role in assisting SAFU Head with day to day work in the department. Provide support to the management personnel by effectively managing his/her schedule and performing a wide variety of responsible, complex and confidential administrative, secretarial, and analytical and research duties. Much of the work is self-appointed, and requires a high degree of professional independence, initiative and self-discipline.

Job Responsibilities

• Daily monitoring of all NAFU triggered cases Trigger State specific fraud cases
• Ensure all triggered cases are handled within TAT Maintain record of all triggered cases and the outcomes Support in fraud control measures
• Preparation of data and analyze it to show trends Support in field audit, death audit and desk audit Support in SAFU Related work
• Monitoring of hospitals to ensure no fraud is being conducted Regular monitoring of BIS
• Compliance of letters received from NHA related to fraud.
• Undertake any additional responsibilities given by the State Health Agency.

Education Qualification/Required Skills & Experience

Qualification:

• Science graduate with 2 year regular Master Degree in Hospital Management/ Hospital Administration/ Health
• Administration/ Health Management from a recognised University/Institution.

Experience

• Minimum 5 years managerial work experience in Hospital having a minimum of 200 bed capacity.

Desired Skills:

• Proficient computer skills, including Microsoft Office Suite (Word, PowerPoint, Outlook, and Excel) Ability to analyze problems and strategize for better solutions
• Ability to negotiate, establish, and administer contracts Excellent verbal and written communication skills
• Ability to multitask, prioritize, and manage time efficiently
• Accurate and precise attention to detail

Age:

• Minimum age to apply is 21 years
• Maximum age: UR/EWS • 40, UR/EWS (W) • 43, BC/EBC (Male & Female) - 43, SC/ST(Male & Femalej - 45, 10 Years relaxation in age will be admissible to persons with Benchmark Disability

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