医院医疗保险人才队伍管理建设的研究与思考  

Research and Consideration on the Management and Construction of Medical Insurance Talents in Hospitals

作　　者：付晓萌[1] 李兰翠[1] FU Xiaomeng;LI Lancui(Medical Insurance Department, Tianjin Huanhu Hospital, Tianjin 300350, China)

机构地区：[1]天津市环湖医院医保科

出　　处：《继续医学教育》2019年第8期75-77,共3页Continuing Medical Education

摘　　要：医疗保险事业惠及民生,医院医疗保险管理是医保政策落实与实施的基础。医院医疗保险从业人员综合能力的提升,是医院医保管理工作高效运行的重要保障。随着我国新型医疗体制改革工作的不断推进,在机遇与挑战并存的新形势下,作为“医”“保”“患”三方的桥梁与纽带,对医院医疗保险人才队伍的管理与建设进行研究思考,有助于了解医院医疗保险管理的要点与难点,对需要医疗保险从业人员掌控的医院医保管理工作流程和环节再造起到积极的推动作用。认为,医院医疗保险管理从业人员,必须加强自身建设、不断提升综合素质,积极引导其进行继续教育与专业培训,以完善的考评与激励机制为依托,才能更好地贯彻落实医疗保险政策,服务于广大参保患者,从而推进我国医疗保险管理事业健康的、可持续性发展。Medical insurance benefits people's livelihood. Hospital medical insurance management is the basis of the implementation of medical insurance policy. The improvement of comprehensive ability of medical insurance practitioners in hospitals is an important guarantee for the efficient operation of medical insurance management in hospitals. With the continuous advancement of the reform of the new medical system in China, medical insurance practitioner is the bridge that interlinkage "medicine","insurance" and "patient" under the new situation of coexistence of opportunities and challenges. It is essential to understand the key points and difficulties of hospital medical insurance management by researching the people management and construction. It plays an active role in promoting the process and link reengineering of hospital medical insurance management, which needs to be controlled by medical insurance practitioners. So it is important for hospital medical insurance management practitioners to strengthen self-construction, constantly improve comprehensive quality and be actively guided to continue education and professional training. In order to implement the medical insurance policy well and serve for most of insured patients, it is essential to rely on a reasonable evaluation and incentive mechanism. If these be done well, medical insurance management in China will develop healthily and sustainably .

关 键 词：医疗保险 医疗保险从业人员 人才建设 

分 类 号：R197.3[医药卫生—卫生事业管理]