Introduction
The organization invites applications from qualified, dedicated, and performance-driven professionals for the position of Benefits Management Officer I. This opportunity provides an avenue for competent individuals to contribute to the effective and sustainable management of health benefits within the national health financing framework. The successful candidates will play a key role in ensuring that the operations of health benefit schemes are aligned with national health objectives, financial sustainability, and efficient service delivery.
This position is central to the development and implementation of benefit packages and tariff structures that uphold equity, cost-effectiveness, and quality healthcare for all citizens. It offers an opportunity to engage in collaborative policy implementation, evidence-based decision-making, and strategic health financing that impacts millions of people. The selected officers will work in a dynamic environment that demands analytical precision, stakeholder engagement, and adherence to best practices in health benefits administration.
Job Term: Permanent and Pensionable
Position Level: SHA 7
Number of Positions: 4
Job Summary
The Benefits Management Officer I will assist in implementing the operational plan for Health Benefits Management. This includes conducting risk assessments, supporting strategic purchasing of benefit packages, ensuring affordability, and analyzing cost-effectiveness. The role involves working closely with other directorates and departments to operationalize policies and strategies that strengthen the health benefits system.
The officers will also take part in policy implementation, data analysis for benefit management, and developing mechanisms for efficient service delivery under various social health insurance funds. The work requires a strong grasp of analytical methods, an understanding of healthcare financing systems, and the ability to coordinate multi-sectoral partnerships.
Key Responsibilities
- Implementation of Operational Plans
The officer will be responsible for implementing the operational plan for Health Benefits Management in line with strategic objectives and in collaboration with other departments. This includes conducting risk assessments, tracking performance indicators, and ensuring that the department’s activities align with the organization’s broader goals. - Policy Implementation and Strategy Development
The officer will participate in the implementation of policies and strategies designed to ensure effective and efficient management of health benefits. This includes contributing to the development of frameworks and operational guidelines that promote the sustainability of benefit packages and equitable access to healthcare. - Strategic Purchasing of Health Benefits
The role involves supporting the strategic purchasing of prescribed benefit packages in close collaboration with the Directorate of Fund Management and other relevant departments. The officer will ensure that purchasing decisions promote efficiency, equity, and cost-effectiveness in healthcare service delivery across different levels of health facilities. - Collaboration with Advisory Panels
The officer will participate in collaborations with the Health Benefits Package and Tariffs Advisory Panel. This entails contributing to the design, review, and updating of benefit packages and tariffs based on evidence, cost data, and changing healthcare needs. The aim is to maintain relevance, affordability, and quality in the benefits offered. - Implementation of Prescribed Benefit Packages
The officer will be responsible for implementing the prescribed benefit packages and tariffs under multiple schemes. These include:- The Primary Healthcare Fund, applicable to level 2, 3, and selected level 4 providers.
- The Social Health Insurance Fund, applied at levels 4, 5, and 6 providers and facilities.
- The Emergency, Chronic and Critical Illness Fund, which covers levels 2 to 6 facilities.
The officer will ensure that the implementation aligns with the principles of cost-effectiveness, equity, and transparency.
- Cost-Effectiveness and Affordability Analysis
A key component of the role is to analyze the cost-effectiveness, affordability, and budget impact of existing and proposed health benefit offerings. The officer will identify areas for optimization to maintain long-term sustainability of health benefit schemes and recommend appropriate measures to improve value for money. - Stakeholder Engagement and Transparency
The officer will collaborate with the Benefit Package and Tariffs Advisory Panel to ensure that the design, review, and implementation processes of benefit packages and tariffs are transparent and inclusive. This involves active engagement with stakeholders, including healthcare providers, professional associations, and policymakers, to build trust and alignment in benefit management processes. - Benefits and Tariffs Management Information Systems
The officer will participate in implementing and improving management information systems related to benefits and tariffs. This includes ensuring that these systems support efficient operations, timely reporting, and enhanced member satisfaction. The officer will contribute to the development of tools and mechanisms that simplify benefit management processes. - Claims and Data Management
The officer will collect and analyze data for purposes of claim management, working in close collaboration with other departments. This includes verifying claims information, ensuring data integrity, and identifying trends that can inform decisions on benefit utilization, fraud prevention, and cost containment. - Reporting and Performance Analysis
The officer will prepare analytical reports on benefits management performance. These reports will include data on utilization trends, financial impacts, and emerging risks. The officer will also provide evidence-based recommendations to management for improving benefits design and delivery. - Collaboration with External Stakeholders
The role requires maintaining effective collaboration with external partners to ensure transparency, accountability, and trust in the management of health benefits. These partners may include healthcare providers, insurance administrators, professional bodies, and regulatory agencies. - Internal Controls and Compliance
The officer will implement robust internal controls to safeguard the sustainability, affordability, and integrity of benefit packages. This includes ensuring compliance with policies, financial standards, and ethical requirements that govern the management of public health funds. - Adherence to Local and International Standards
The officer will ensure that benefits management activities align with both local laws and international standards. This involves fostering alignment with globally recognized best practices, improving institutional credibility, and ensuring compliance with regulatory frameworks prescribed in the Social Health Insurance Act. - Business Process Re-engineering
The officer will implement strategies for business process re-engineering aimed at driving innovation and efficiency within benefits management functions. This may include reviewing workflows, adopting digital tools, and identifying operational bottlenecks to enhance service delivery. - Policy and Legislative Review
The officer will contribute expert guidance on reviewing and amending provisions within the Social Health Insurance Act related to benefits management. This includes ensuring that the policy framework remains responsive to emerging healthcare needs and that it meets evolving quality and equity standards. - Cross-Departmental Coordination
Effective coordination with departments such as Fund Management, Health Financing, and Claims Processing will be essential to ensure that benefit implementation processes are harmonized and that information flows efficiently across departments. - Monitoring and Evaluation
The officer will support the establishment of monitoring frameworks to evaluate the performance of benefit packages and their impact on health outcomes. Data generated from these evaluations will be used to improve design and delivery. - Technical Support and Guidance
The officer will provide technical input in the development and rollout of new benefit programs. This includes contributing to feasibility assessments, stakeholder consultations, and operational guideline formulation. - Risk Management
The officer will take part in assessing and mitigating risks associated with benefit implementation, ensuring that potential financial and operational risks are managed effectively. - Continuous Improvement
The role emphasizes continuous improvement through feedback analysis, review of operational data, and adoption of innovative methods that enhance the efficiency of benefits management systems.
Summary of Core Competencies and Functional Expectations
The Benefits Management Officer I is expected to demonstrate proficiency in the following areas:
- Analytical and data interpretation skills for effective decision-making.
- Sound understanding of healthcare financing mechanisms and benefit design principles.
- Strong collaboration and communication skills for stakeholder engagement.
- Capacity to ensure compliance and uphold transparency in benefit management processes.
- Ability to apply evidence-based approaches in reviewing, designing, and implementing benefit packages.
- Commitment to maintaining service quality, cost efficiency, and financial sustainability.
- Technical understanding of benefit management information systems and data-driven tools.
The position offers a unique opportunity for professionals seeking to contribute to the improvement of national health systems through evidence-based benefit management. The selected candidates will play an instrumental role in ensuring that healthcare financing mechanisms remain sustainable, equitable, and responsive to changing population needs.
Working Environment and Expectations
The Benefits Management Officer I will operate in a professional environment characterized by cross-departmental collaboration and a strong focus on performance outcomes. The officer will interact regularly with senior management, technical teams, and external partners, ensuring alignment of strategies and effective communication across different operational levels.
The role requires a high level of accuracy, integrity, and analytical acumen. The officer must be able to interpret complex data, draft well-structured reports, and make informed recommendations that support policy implementation and operational efficiency. The officer will also be expected to observe strict adherence to ethical and professional standards in all aspects of work.
This position provides opportunities for professional development, exposure to diverse operational areas within health financing, and contribution to impactful reforms that improve access to healthcare services. The officer will be expected to uphold the institution’s values of transparency, accountability, and service excellence.
Application Process
Interested candidates who meet the above criteria are invited to submit their applications. Detailed applications should include a cover letter and a comprehensive resume highlighting relevant experience, current responsibilities, and professional achievements. Applications should be addressed and submitted as per the instructions provided in the official advertisement.
