Sub Category

Trainee / Graduate Jobs

Administrative Jobs in Nigeria

Advertising Jobs Nigeria

Accounting Jobs in Nigeria

Auditing Jobs Nigeria

Arts Jobs in Nigeria

Android / IOS Developer Jobs

Agriculture Jobs in Nigeria

Architecture Jobs in Nigeria

Aviation Jobs in Nigeria

Automobile Jobs in Nigeria

Banking Jobs in Nigeria

Computer & InfoTech Jobs

Computer / IT Support Jobs

Customer Service Jobs

Civil Engineering Jobs

Cook / Chef Jobs

Database Jobs in Nigeria

Driving / Dispatch Rider Jobs

Education Jobs for Nigerians

Real Estate Jobs

Electrical/Electronics Jobs

Engineering Jobs in Nigeria

Facility Mgt Jobs in Nigeria

Finance Jobs in Nigeria

Front Desk Jobs in Nigeria

Geology Jobs

Government Jobs in Nigeria-

Graphics Design Jobs

Hospitality Jobs in Nigeria

Hotel Jobs in Nigeria

HR Jobs in Nigeria

Industrial Attachment (Internship)

Insurance Jobs in Nigeria

Journalism / Content Writing Jobs

Law Enforcement / Security Jobs

Lecturing Jobs in Nigeria

Law / Legal Jobs in Nigeria

Linux & Unix Jobs Nigeria

Marketing & Sales Jobs

Maritime & Shipping Jobs

Medical & Healthcare Jobs

Military Jobs in Nigeria

Computer Networking Jobs

NGO Jobs in Nigeria

Oil & Gas Jobs in Nigeria

Oracle Jobs in Nigeria

Personal Assistant Jobs

PHP & MySQL Jobs in Nigeria

Physician / Medical Officer Jobs

Public Relation Jobs

Programming / Software Jobs

Pri/Sec Sch Teaching Jobs

Real Estate Jobs in Nigeria

Remote / Work-at-home Jobs

Research Jobs in Nigeria

Safety & Health Jobs

Secretarial Jobs in Nigeria

Security Jobs in Nigeria

Sales Jobs

Shipping & Maritime Jobs

Student Jobs in Nigeria

Software Developer Jobs

System Admin Jobs in Nigeria

Teaching Jobs in Nigeria

Telecommunication Jobs

Semi-skilled / Factory Work

Volunteer Jobs Nigeria

Web Developer Jobs Nigeria

Web Designer / Frontend / UI Jobs


Job Filter

Get Latest Nigerian Jobs Alert!
Enter your email below.










  
          Popular Jobs
Zojatech Limited Graduate & Exp. Job Recruitment (6 Positions)

Beacongate Limited Job Recruitment (5 Positions)

Jibs-Ray Nigeria Limited Job Recruitment (3 Positions)

Khenpro Global Services Job Recruitment (9 Positions)

Amaiden Energy Nigeria Limited Job Recruitment (4 Positions)

Nestoil Limited Job Recruitment (5 Positions)

Yardoak Project Graduate & Exp. Job Recruitment (4 Positions)

HR-Light Consult Job Recruitment (4 Positions)

Fadac Resources and Services Limited Job Recruitment (8 Positions)

Roducate Limited Job Recruitment (3 Positions)

IO Furniture Limited Job Recruitment (5 Positions)

Scrapays Plc Job Recruitment (4 Positions)

Babban Gona Farmer Services Nigeria Limited Job Recruitment (3 Positions)

Schlumberger Limited Job Recruitment

Alfred and Victoria Associates Job Recruitment (7 Positions)

TotalEnergies Nigeria International Masters Degree Scholarship 2024

Advantage Health Africa Job Recruitment (4 Positions)

Odixcity Consulting Job Recruitment (9 Positions)

Agurate Online Limited Job Recruitment (4 Positions)

HR-EX Consulting Job Recruitment (7 Positions)

Kennedia Consulting Limited Job Recruitment (4 Positions)

Goldplates Feast House Job Recruitment (4 Positions)

Prestigious Consulting Group Job Recruitment (4 Positions)

Sun King (Formerly Greenlight Planet) Job Recruitment (4 Positions)

Coca-Cola Hellenic Bottling Company Job Recruitment (5 Positions)

Moniepoint Incorporated Job Recruitment (6 Positions)

DMOT Enterprises Job Recruitment (3 Positions)

Excel and Grace Consulting Job Recruitment (13 Positions)

MPI Group Job Recruitment (6 Positions)

Givanas Group Job Recruitment (9 Positions)

Golden Oil Industries Limited Job Recruitment (3 Positions)

Global Profilers Job Recruitment (13 Positions)

Repton Group Job Recruitment (6 Positions)

Medecins Sans Frontieres (MSF) Job Recruitment (5 Positions)

FinTrak Software Company Limited Job Recruitment (3 Positions)

Food Concepts Plc Job Recruitment (5 Positions)

Vesti Graduate Trainee Programme 2024

Aureole Consulting Limited Job Recruitment (6 Positions)

U.S. Mission in Nigeria Job Recruitment (9 Positions)

Malaria Consortium Job Recruitment (9 Positions)

Smart Partners Consulting Limited Job Recruitment (7 Positions)

Kaltani Job Recruitment (4 Positions)

Vixa Pharmaceutical Company Limited Job Recruitment (5 Positions)

West Africa Vocational Education (WAVE) Job Recruitment (7 Positions)

Concept Group Job Recruitment (8 Positions)

Reliance Health Job Recruitment (4 Positions)

Zenith Care Hospital Job Recruitment (3 Positions)

Wema Bank Plc Job Recruitment (7 Positions)

Danish Refugee Council (DRC) Job Recruitment (6 Positions)

President Paints Limited Job Recruitment (3 Positions)


Program Officer, Claims Management and Payment Processes (Consultancy) at Palladium Group

Posted on Wed 20th Mar, 2019 - hotnigerianjobs.com --- (0 comments)


Palladium is a global leader in the design, development and delivery of Positive Impact - the intentional creation of enduring social and economic value. We work with foundations, investors, governments, corporations, communities and civil society to formulate strategies and implement solutions that generate lasting social, environmental and financial benefits.

For the past 50 years, we have been making Positive Impact possible. With a team of more than 2,500 employees operating in 90 plus countries and a global network of more than 35,000 technical experts, Palladium has improved - and is committed to continuing to improve - economies, societies and most importantly, people's lives.

We are recruiting to fill the position below:

Job Title: Program Officer, Claims Management and Payment Processes (Consultancy)

Location
: Abuja (with regular travel to the States)
Reporting: The Secretariat of the National Steering Committee (TS-NSC)

Background
  • Nigeria has committed to achieving Universal Health Coverage (UHC) and has put in place the enabling policy1 to achieve this. At the Federal level, there’s the recognition of the role of States as drivers and providers of primary health care service delivery. This is consistent with the ‘Bringing PHC under One Roof’ (PHCUOR) policy that was instituted and ratified by the National Council on Health in 2011. The policy aims to strengthen PHC systems through the creation of State PHC Boards that would allow for integration and/or decentralization of PHC services management.
  • Whilst acknowledging the separation of functions and the role of States in the management and organization of performance for PHC service delivery, a National Health Act (NHAct) was enacted into law in 2014. The NHAct specifies that all Nigerians shall be entitled to a Basic Minimum Package of Health Services (BMPHS). With the BMPHS, Nigeria aims to create a minimum “health floor” and provide a defined set of services for all Nigerians in line with its UHC goals.
  • To guarantee the BMHPS, the Basic Health Care Provision Fund (BHCPF) was established under Section 11 of the National Health Act, as its principal funding vehicle for the BMPHS.
Job Summary
  • The Federal Ministry of Health in; conjunction with NPHCDA & NHIS have developed the operations manual for the roll out of the implementation of BHCPF. To ensure adequate governance for the program, the secretariat has been set up to provide stewardship of fund use and program execution.
  • Consistent with the tenets of the NHAct, the funds will be:
    • Used in strengthening service delivery by providing accredited PHCs with operational expenses and;
    • Purchasing the BMPHS for beneficiaries.
  • The BHCPF will be implemented in the 18 States + FCT.
  • The TS=NSC seeks to hire a suitable candidate to provide the framework for the reimbursements; of services rendered, support State teams with claims verification and processing and broader strategic purchasing approach. Amidst concerns of high financial barriers to accessing care at the PHC level, it is necessary to reduce out of pocket expenses paid at the point of use, reimburse facilities swiftly for services rendered, and maintain a solid IT platform to support the process.
In this role, the candidate will work closely with the relevant agencies at federal and state level:
  • Evaluate different provider payment method options for different levels of care, with the ultimate objective of using incentives to improve health care quality and minimize the risk of opportunistic behavior amongst accredited health care providers;
  • Develop context specific strategic purchasing approaches that are geared towards allocative efficiencies and incentivize high quality of care;
  • Design and develop templates for the claims documentation and submission by healthcare facilities;
  • Develop materials documenting processes for case management by the purchaser at the state level, with input from relevant state policymakers (e.g. state-sponsored health insurance leaders, when applicable), with a focus on effective and efficient verification of claims;
  • Design and support the States to adopt a coding system for documentation of healthcare services and claims processing;
  • Design and develop standard operating procedures for claims submission, management and reimbursement;
  • Determine and itemize the linkages between claims form and the District& Health Information System (DHIS) reporting platform, with a view to ensuring alignment;
  • Design and develop monitoring and evaluation mechanisms to continually track claims reimbursement operations, identify bottlenecks and present leadership with solutions to address these;
  • Develop standard operating procedures for fraud detection and management;
  • Through the secretariat, engage with NHIS, NPHCDA, FMOH, State level and other stakeholders to foster collaboration on and adoption of the deliverables listed in this ToR;
  • Train and support State teams in claims verification, recording and payment;
  • Support in the development and documentation of a provider payment system - method of reimbursing providers for services rendered, classification of product, counting of reimbursed services, tariff setting (pricing), and reporting.
Other functions will include but not limited to:
  • Represent the organization at the highest levels in specific technical areas and provide leadership in the fields of strategic purchasing, claims processing and payment systems;
  • Liaise with technical and programmatic leaders from various federal, parastatal and state level institutions as necessary in order to perform the above tasks;
  • Continually identify and implement opportunities for TMSOF to add value and maximize impact through well-designed provider payment mechanisms;
  • Ensure proper execution of required initiatives to strengthening the claims management systems
  • Assist other units in related elements of their work
  • Perform any other tasks as designated.
Requirements
Qualifications and Experience:
  • Minimum of a Master's level qualification from an internationally recognized University in Health Economics or Economics or Financial Management / Accounting
  • Minimum of seven years’ experience working in a related function in a Health Management Organization preferably in a Nigerian context.
  • Significant proven practical experience of claims data processing and design of payment mechanisms. Ideally candidates will have played a role in reviewing a national program.
  • Minimum of 7 years of experience in designing, administering, implementing or monitoring a national or subnational (state) level provider payment system
  • Experience of results’ delivery of programmes.
  • Proven cultural, social and political sensitivity of working in Nigeria at different levels of government.
Technical Competencies:
  • This role requires a combination of technical and management skills. Primary competencies include:
    • Proficiency in using Microsoft packages
    • Demonstrated ability to conduct quantitative analysis
    • Ability to build and foster collaborative relationships with relevant partners to inform programmes and policy
    • Make effective decisions using complex data, policy documents and similar information on health financing issues
    • Ability to demonstrate a degree of specialist knowledge and results in three following core areas:
      • Health Insurance
      • Clinical Care Management
      • Advocacy
Behavioral Competencies:
  • Capture: Ability to assess and interpret information to use it to inform non-technical colleagues
  • Deliver at pace: Ensure tasks are done to the required standard and deadlines; plan work to meet individual, team and office wide objectives.
  • Lead and communicate: Communicate clearly both orally and in writing, using appropriate language; communicate on a range of issues to diverse internal and external audiences.
  • Collaborate and partner: Excellent team player; ability to work effectively with government, development partners, civil society and private sector stakeholders, including traditional and religious leaders; ability to build good relationships for partnership, implementation, and support for the working group’s programmes.
  • Contextualize: Ability to develop an in-depth understanding and knowledge of how the role fits and supports organizational objectives and wider public needs.
Applications Close Date
25th March, 2019.

How to Apply
Interested and qualified candidates should:
Click here to apply online

  

Comments (0)


Post a Comment
Name: *
Email: *
Comment: *