Tech. Support Consultant for the Osun Health Insurance Scheme at Palladium Group

Project Overview and Role   

• The Osun state Government has signed into law, a bill that establishes the Osun State Health Insurance Scheme (OHIS) with the overall goal of ensuring all residents of the state have access to quality and affordable health care services with financial and social risk protection. As part of the design of the scheme, a health benefits package and operational guidelines have been developed.
• The overall aim of this consultancy is to support internal support to the OHIS agency in defining the necessary structures, processes and mechanisms for the implementation of OHIS using evidence generated from the state, in keeping with best practice and based on the state’s context that will ensure a viable and sustainable OHIS.
• Expected Period of performance of the consultant: 10th December to July 15th 2018.

Responsibilities
Specific Objectives:

• Develop key structures, mechanisms and processes for the implementation of OHIS, drawing from best practices in keeping with the state’s context.
• Build capacity of the OHIS staff to successfully implement the scheme
• Support the roll out/implementation of OHIS while ensuring the best possible standards.
• Develop and implement a comprehensive M&E system for tracking the progress of the scheme and improving the achievement of the goals of OHIS towards UHC.

Key Activities
The Consultant shall work with OHIS management, staff and supporting partners to:

• Work with OHIS staff to develop operational structures and processes for OHIS including enrolment, accreditation and facility selection, empanelment, claims management, quality assurance, TPA engagement, financial management, monitoring and evaluation, ICT, communication plans and other required processes for the implementation of the scheme
• Develop a comprehensive and feasible business process for the OHIS
• Build the capacity of the OHIS staff on these processes to successfully implement the scheme
• Develop manuals as required including PPM guidelines, Financial management manual, TPA guidelines, claims management, quality assurance, M& E manuals and others necessary for the scheme
• Develop necessary operational documents including contracts, agreements, M&E forms as required and build capacity for their utilization.
• Support the development of service charges, tariffs, drug lists and treatment protocols for OHIS.
• Support the roll out and M&E of these activities to ensure its practicability.

Requirements
Skills and Expertise Required:

The consultant and possess the following;

• An advanced degree in Medicine, Public Health, Health Economics, Finance, Insurance and Actuarial Science or other quantitative fields with about 7 years’ experience in this field.
• Strong knowledge of health insurance operations and the procedures
• Experience working with a health HMO in Nigeria.
• Familiarity with Universal Health Coverage agenda and goals and knowledge of Nigerian government policy direction.
• Experience in supporting the design and operations of State Health Insurance Schemes(SHIS)
• Effective written and verbal communication skills in presenting recommendations to non-actuaries.
• Advanced computing knowledge and high proficiency in use of Office applications.