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  • Posted: Dec 5, 2018
    Deadline: Dec 12, 2018
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    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 governments, businesses, and investors to solve the world's most pressing challenges. With a team of more than 3,000 employees operating in 90 plus countries and a global network of over 35,000 experts, we help improve economies, societies and, most importantly, people's lives.
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    Tech. Support Consultant for the Osun Health Insurance Scheme

    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.

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    Health Systems Strengthening (HSS) Coordinator - Nigeria IHP

    Reports to:  The Kebbi IHP Governance and Leadership advisor

    Project Overview and Role   

    • The Health System Coordinators shall be based at strategically located Local Government Health Authorities (LGHAs).
    • The IHP Health System Strengthening (HSS) coordinators will be responsible for providing technical assistance and capacity building across the building blocks of the health system and enhance the utilization of data for decision-making and apply adaptive management at the LGHA  (6-7), PHC and community to continually strengthen accountability, systems and services for  reduced child and maternal morbidity and mortality.

    Responsibilities   

    • Facilitate and support LGHA officials to adopt and effectively implement state-wide policies including, but not limited to, Primary Health Care Under One Roof (PHCUOR), PHC revitalization, Integrated Supportive Supervision, and integrated RMNCH+N and malaria
    • Build capacity of LGHAs to strengthen Facility Management Committees (FMC), Quality Improvement Teams and Ward Development Committees (WDCs) to fulfill their functions and work with health providers to improve integrated primary health care
    • Provide guidance to LGHA’s to enhance HRH availability and performance of integrated primary health care through appropriate training, mentoring and integrated supportive supervision to facility (PHC) and community-based structures (WDCs/VDCs and community-based health workers/volunteers)
    • Support the implementation of strategic plans for Human Resources for Health at the LGHA and PHC levels that are based on evidence and are designed to support improvements in RMNCH+N and malaria
    • Provide technical leadership to and build capacity of LGHA officials to use available data and information to make strategic decisions for planning, budgeting and supervising systems for health financing, health workforce, service delivery, supply chain, governance and accountability
    • Works with LGHAs to strengthen institutional and financial capacity for quality PHC service delivery, incorporating new and innovative approaches as appropriate for FMCs and WDCs
    • Participate in catchment LGHAs’ planning meetings, to provide guidance and adapt/target IHP technical assistance plans, as necessary to address needs
    • Conduct regular internal review and analysis of program and quality improvement data for catchment LGHAs to determine progress towards goals and gaps and develop plans for technical assistance to address gaps
    • Provide support to LGHA and facility officials to explore opportunities to collaborate with the private sector to improve RMNCH health outcomes
    • Coordinate scheduling of program-wide technical assistance activities for catchment LGHAs
    • Provide clear documentation of programmatic achievements and keep state management team informed on monthly, quarterly and annual basis
    • Perform other duties as assigned by supervisor which contribute to the achievement of program goals

    Requirements

    • A graduate degree in Public Health, Health planning, Health policy or related courses (e.g. MBBS, RN etc.) with extensive field experience in managing health programs in Nigeria. A postgraduate degree in health systems or public health will be an added advantage
    • At least 3-5 years of experience working on Health Systems Strengthening in developing countries, preferably in Nigeria
    • The HSS Coordinator must be an experienced professional in the field of health systems strengthening, primary health care, and have capacity building and project management experience in public health programs
    • The HSS Coordinator must be intimately familiar with the context in Nigeria and have in-country experience with USAID programs
    • Demonstratable capacity to network and negotiate with key stakeholders across different sectors in support of health
    • Strong skills in design, implementation and monitoring of program components; e.g. health systems strengthening, qual training, supportive supervision, advocacy and coordination
    • Excellent facilitation and mentoring skills’ supporting decentralized entities to translate policies into strategic plans for implementation; and computer literacy in spread sheets is a must
    • Experience with technical assistance for programs funded by USAID and/or other donor programs in developing countries, with significant Nigeria experience
    • Strong verbal, listening, writing, and interpersonal skills essential for effective coordination among several institutions and staff involved in a broad range of activities
    • Fluent in English, (written and oral communication) and Hausa and/or Fulfulde
    • Willingness to travel throughout Kebbi state as necessary

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    Consultant - Actuarial Analysis of the Osun State Health Insurance Scheme

    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 has been developed to ascertain the health services to be provided as entitlement to enrollees on the scheme.
    • The overall aim of this consultancy is to support the pricing of the Osun benefit package and determine an actuarially fair priced premium including the appropriate distribution of medical claim costs, admin costs and reserve margin and the appropriate payments for capitation and fee for service for providers in order to inform the selection of a financially sustainable premium and processes for OHIS.

    Responsibilities
    Deliverables:

    • A comprehensive actuarial study report for the Osun benefit package scenarios containing:
    • Appropriate premium (Individual and Family package) to cover medical costs, overhead administrative costs, and reserve margin of the scheme.
    • Determination of an appropriate premium rate for individual/household package and additional family members.
    • Modular pricing for the Osun benefit package including the different scenarios and disease conditions for individual and household packages.
    • Rates for medical payouts (Capitation fee and Fee-for-Service), including tariff structure for procedures, consultations, pharmaceuticals and diagnostics.
    • Rates for administration fee to HIAs/TPAs/OHIS.
    • Expected Period of performance of the consultant: 10th December to January 15th 2018.

    Requirements
    Skills and Expertise Required:

    The consultant should be a licensed actuary and possess the following:

    • An advanced Degree in Mathematics, Statistics, Finance, Insurance and Actuarial Science or other quantitative fields with about 7 years' experience in this field.
    • 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 use of Spreadsheet applications.
    • Membership of Chartered Insurance Institute of Nigeria will be an added advantage.

    Method of Application

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