Actuary at Health Systems Consult Limited (HSCL)

Reports to: Project Manager
Type of Contract: Fixed Term
Expected Duration of Assignment: 18 months

Project background

• The Nigerian health system is weak and unresponsive as a result of years of grappling with poor infrastructure, inadequate equipment and technology, inadequate number and mix of healthcare workers, poor capacity of health sector stakeholders, poor information management/sharing mechanisms and under investment by the government. Against this backdrop, the country struggles in the move towards achieving Universal Health Coverage (UHC). As many countries continue to progress towards the achievement of UHC goals, sustainable mechanisms for financing healthcare, improvements in human resources for health management and budget processes for health as well as strengthening systems for health accounts have been identified as crucial.
• The Global Fund’s Catalytic Health System Investment Programme for prioritised states in Nigeria including Kaduna, Imo and Oyo clearly identifies a number of key interventions to strengthen health systems in the focus states. These interventions include amongst others:
  • Strengthen public financial management (PFM) capacity of the Ministries of Health in Kaduna, Imo and Oyo to develop, execute and advocate for realistic and evidence-based spending on health in line with international best practices;
  • Conduct necessary costing/actuarial analysis and roll-out supportof state health insurance schemes;
  • Assess Health Labour Market; and,
  • Carry out and update state health accounts.

Job Purpose

• The Actuary will provide technical support to respective State Contributory Health Agencies for the design of the benefit package and premium determination for the schemes using scientifically rigorous approaches.

Duties and responsibilities
Summary of Key Functions:

• A comprehensive actuarial study reports for the states’ (Kaduna, Imo, Oyo) benefit package scenarios containing:
• Determination of an appropriate premium rate for (Individual, Householdpackage and additional household members) to cover medical costs (pure risk premium), overhead administrative costs, operating expenses and contingency/reserve margin of the scheme.
• Rates for tariff structure for procedures, consultations, pharmaceuticals and diagnostics.
• Develop costing models to develop actual costing estimates based on States’ realities (including current demographic distributions, treatment protocol, prices etc); the consultant will work with the State (by on-the-job support and capacity building) to prepare costs of the Benefit Package and the feasible premium for each package.
• Based on previously conducted fiscal space analysis (FSA) and by running new quantitative and qualitative models for further evidence, the consultant will develop recommendations for possible funding sources for the scheme;
• This will include range of formal and informal sector contributions and estimated premium amounts that will ensure sustainable financing of the scheme during the first year;
• This analysis will be developed in a way that could serve as a base for further actuarial modelling and analysis to develop options for long-term sustainability of the scheme.
• Among other things, the consultant will explore Nigeria’s National Bureau of Statistics (NBS) and other approved data including but not limited to the states’ Household Survey and Willingness/Ability to Pay Survey to estimate current levels of average household health expenditure and develop recommended contribution amounts based on the estimated ability to pay among states’ residents.
• The consultant will also provide recommendations for provider payment amounts based on the provider payment mechanism advised by the States and the implementation partners (e.g. capitation, FFS etc.)
• Carry out other relevant tasks as the Project Manager may assign

Competencies

• Outstanding analytical skills
• Strong statistical, analytical and monitoring skills with solid understanding of all life/disability actuarial techniques, standards, and assumptions
• Strong knowledge of insurance operations and the procedures of Financial, Underwriting, Claims, Statistical, Information Technology, Legal, and Sales departments
• Experience in conducting actuarial analysis for health insurance in Nigeria.
• Must have led rate-making and pricing initiatives for insurance products.
• Effective written and verbal communication skills in presenting recommendations to non-actuaries.
• Advanced computing knowledge and high proficiency in the use of Spreadsheet applications.
• Membership of Chartered Insurance Institute of Nigeria will be an added advantage
• Knowledge of the Nigerian health sector and health financing landscape
• Consistently approach work with energy and a positive, constructive attitude;
• Demonstrate strong oral and written communication skills

Educational Qualification and Experience
Education:

• An advanced Degree in Mathematics, Statistics, Finance, Insurance and Actuarial Science or other quantitative fields.

Work Experience:

• At least 8 years’ relevant experience