Benefits Management Officer II Jobs at The Social Health Authority (SHA)

Minimum Qualifications:
Bachelors Degree
Job Term:
Permanent and Pensionable
Position Level:
SHA 8
Number of positions:
4

Qualifications, Skills and Experience Required:
For appointment to this grade, a candidate must have:
1. Bachelor’s degree in any of the following disciplines: Pharmacy, Health Financing, Health Economics, Actuarial Sciences, Statistics, Nursing, Mathematics, Dentistry, or its equivalent from a recognized institution.
2. Membership with a relevant professional body, where applicable and in good standing;
3. Proficiency in Computer applications.
4. Shown merit and ability as reflected in work performance and results.
Responsibilities:
You will assist in implementing the operational plan for Health Benefits management, including risk assessments, strategic purchasing of benefit packages, and analysis of cost-effectiveness.
This is the entry and training grade for this cadre. An officer at this level will work under the guidance of a senior officer.

Key responsibilities
1. Supporting operational planning for Health Benefits management, risk assessments and monitoring performance against strategic objectives in collaboration with other departments.
2. Assisting Formulation and implementation of policies and strategies for effective and efficient Health Benefits management in collaboration with other departments.
3. Supporting the strategic purchasing of prescribed benefit packages in close collaboration with the Directorate of Fund Management and other departments ensuring efficiency, equity, and cost-effectiveness in service delivery.
4. Assisting in collaborations with the health Benefits Package & Tariffs Advisory Panel in evidence-based designing, reviewing, and updating of Benefit packages and Tariffs.
5. Implementing of the prescribed Benefits packages and Tariffs under the Primary Healthcare Fund for level 2, 3 and select 4 providers and facilities; under the Social Health Insurance Fund in level 4, 5 and 6 providers and facilities and the Emergency, Chronic and Critical Illness Fund in level 2-6 facilities and providers.
6. Participating in Analysing the cost-effectiveness, affordability, budget impact of health benefit offerings and recommend optimizations to maintain sustainability.
7. Supporting collaborations with the Benefit Package & Tariffs Advisory Panel, to ensure the benefits packages and tariffs design, review and implementation processes are transparent and inclusive through stakeholder engagement.
8. Participating in the effective implementation and continuous improvement of Benefits and Tariffs management information systems, ensuring they support efficient operations and member satisfaction.
9. Collecting and analysing data for purposes of claim management in collaboration with other departments.
10. Analysing the cost-effectiveness of benefit offerings and recommend optimizations to maintain sustainability.
11. Supporting the provision of expert guidance in Benefits management on reviewing and amending the Social Health Insurance Act, ensuring responsiveness to the evolving healthcare landscape and adherence to quality standards.