Assistant Director, Benefits Management - 2 Posts at The Social Health Authority (SHA)

Qualifications, Skills and Experience Required:

• Cumulative service period of twelve (12) years relevant work experience, three (3) of which must have been at the grade of Principal Benefits Management Officer or a comparable position.
• Bachelor’s degree in Pharmacy, Health Financing, Health Economics, Actuarial Sciences, Statistics, Nursing, Mathematics, Dentistry, or its equivalent.
• Master’s degree in Health Economics, Health Financing, Statistics, Medicine, Mathematics, Public Health, Health System Management, or its equivalent.
• Membership with a relevant professional body, where applicable and in good standing.
• Certificate in Leadership courses lasting for at least four (4) weeks.
• A valid practicing license where applicable from a recognized institution.
• Proficiency in computer applications.
• Demonstrated managerial, administrative, and professional competence in work performance and results.

Responsibilities:

• Planning Strategic and operational Health Benefits management, risk assessments, and performance monitoring.
• Formulating, implementing, and reviewing policies and strategies for effective Health Benefits management.
• Implementing strategic purchasing of prescribed benefit packages to ensure efficiency, equity, and cost-effectiveness.
• Collaborating with the Health Benefits Package & Tariffs Advisory Panel in evidence-based designing, reviewing, and updating of Benefit packages and Tariffs.
• Implementing prescribed Benefits packages and Tariffs under Primary Healthcare Fund, Social Health Insurance Fund, and Emergency, Chronic and Critical Illness Fund for various facility levels.
• Analysing the cost-effectiveness, affordability, and budget impact of health benefit offerings and recommending optimizations.
• Coordinating the effective implementation and continuous improvement of Benefits and Tariffs management information systems.
• Coordinating data collection and analysis for claim management.
• Compiling reports on Benefits Management.
• Developing, implementing, and reviewing robust internal controls to safeguard the sustainability, affordability, and integrity of benefit packages.
• Ensuring compliance with local and international standards in Benefits Management.
• Coordinating the development and execution of policies and strategies for business process re-engineering.
• Providing expert guidance on reviewing and amending the Social Health Insurance Act.
• Fostering trust and transparency through collaboration with stakeholders.