Analisis Model Kepemimpinan Islami sebagai Strategi Peningkatan Kinerja Karyawan dan Profitabilitas Rumah Sakit Pasca Audit Klaim BPJS

Audit pasca klaim BPJS menjadi tantangan serius bagi Rumah Sakit di Indonesia. Pada tahun 2024 Rumah Sakit mengalami koreksi klaim sebesar pending klaim 23%, audit klaim 56%, gagal klaim 2%, fraud 19%, dispute 0%, akibatnya mengalami penurunan laba bersih. Rumah Sakit perlu mereformasi strategis kepemimpinan berbasis nilai Islami. Penelitian ini bertujuan menganalisis pengaruh kepemimpinan Islami terhadap kinerja karyawan dan profitabilitas rumah sakit pasca audit klaim BPJS.
Desain penelitian menggunakan pendekatan kuantitatif analitik dengan pendekatan cross-sectional, pengumpulan data menggunakan kuesioner melibatkan 60 responden dan studi dokumentasi key performance index serta laporan keuangan. Hasil uji chi-square menunjukkan bahwa kepemimpinan Islami berpengaruh signifikan terhadap kinerja Karyawan p = 0,011 dengan rata-rata kinerja 71,54%. Kepemimpinan Islami belum berpengaruh signifikan p = 0,915 dengan rata-rata nett profit margin -17%, return of asset -2%, dan return of equity -2%. Profitabilitas belum ideal penyebabnya adalah jumlah kunjungan, pembatasan kasus yang ditangani Rumah Sakit, biaya operasional tinggi dan audit klaim BPJS. Penelitian ini menyimpulkan bahwa nilai-nilai Islami seperti amanah, musyawarah, uswatun hasanah, habluminannas dan kolaborasi akal qalb berperan penting dalam memperkuat kedisiplinan dan budaya kerja, namun belum berpengaruh signifikan terhadap profitabilitas tanpa adnya intervensi efisiensi operasional dan dukungan regulasi. Rekomendasi strategis meliputi integrasi nilai Islami ke dalam sistem manajemen melalui penilaian key performance index, mensinergikan nilai Islami dan strategi efisiensi keuangan, peningkatan kinerja pemasaran untuk kerjasama dengan Asuransi non-BPJS serta pengembangan model kepemimpinan Islami secara kontekstual untuk meningkatkan daya adaptif Rumah Sakit secara berkelanjutan

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Post-claim audits by BPJS (Indonesia's National Health Insurance) have become a major challenge for hospitals nationwide. In 2024, the hospital under study experienced significant claim corrections: 23% pending claims, 56% audited claims, 2% rejected claims, 19% fraud, and 0% dispute, resulting in a sharp decline in net profit. Hospitals need to reform their leadership strategies based on Islamic values, particularly through the adoption of Islamic leadership principles. This study aims to analyze the influence of Islamic leadership on employee performance and hospital profitability after BPJS claim audits. The research employed an analytic quantitative design with a cross-sectional approach, involving 60 respondents through questionnaires and documentation review of key performance indicators and financial statements. The chi-square test showed a significant effect of Islamic leadership on employee performance (p = 0.011) with an average performance score of 71.54%. Islamic leadership has not had a significant effect on profitability (p = 0.915) with an average net profit margin of - 17%, return on assets of -2%, and return on equity of -2%. The decline in profitability was mainly attributed to limited patient visits, case restrictions, high operational costs, and post-claim audits. The study concludes that Islamic values such as amanah (trust), musyawarah (consultation), uswatun hasanah (exemplary leadership), habluminannas (interpersonal relations), and the integration of intellect and heart (aql and qalb) play a crucial role in strengthening discipline and work culture. However, these values alone are insufficient to impact profitability without operational efficiency interventions and regulatory support. Strategic recommendations include integrating Islamic values into the management system through KPI evaluations, synergizing Islamic ethics with financial efficiency strategies, enhancing marketing performance by partnering with non-BPJS insurance providers, and developing a contextual Islamic leadership model to enhance the hospital’s long-term adaptive capacity.