Deputy Director, Benefits Management at The Social Health Authority (SHA)

Qualifications, Skills and Experience Required:

• Fifteen (15) years of cumulative service period of relevant work experience, with at least three (3) years at Assistant Director, Benefits Management Officer or comparable. 
• Bachelor’s degree in Actuarial Science, Statistics, Mathematics, Commerce, Business Administration, Risk Management, Insurance, or equivalent from a recognized institution.
• Master’s degree in Actuarial Science, Statistics, Mathematics, Business Administration, Strategic Management, Risk Management, Insurance or equivalent from a recognized institution.
• Membership with a relevant professional body, where applicable and in good standing.
• Certificate in Leadership courses lasting at least four (4) weeks from a recognized institution.
• A valid practicing license where applicable from a recognized institution.
• Proficiency in computer application.
• Demonstrated managerial, administrative, and professional competence in work performance and results.

Responsibilities:

Job Purpose: 

• The role of an actuary (within this cadre) is to provide independent advice on the financial risks facing an insurer; and determine profitability and sustainability of coverage of policies. The primary responsibility is to assess and manage the financial risks associated with reinsurance contracts and portfolios.

Functions: 

• Ensuring strategic and operational planning for Health Benefits management, risk assessments, and monitoring performance against strategic objectives in collaboration with other departments.
• Formulating, implementing, and reviewing policies and strategies for effective and efficient Health Benefits management in collaboration with other departments.
• Coordinating strategic purchasing of prescribed benefit packages in close collaboration with the Directorate of Fund Management and other departments, ensuring efficiency, equity, and cost-effectiveness in service delivery.
• Collaborating with the Health Benefits Package & Tariffs Advisory Panel in evidence-based designing, reviewing, and updating of Benefit packages and Tariffs.
• Coordinating the implementation of prescribed Benefits packages and Tariffs under the Primary Healthcare Fund (for levels 2, 3, and select 4 providers/facilities), Social Health Insurance Fund (for levels 4, 5, and 6 providers/facilities), and the Emergency, Chronic and Critical Illness Fund (for levels 2-6 facilities/providers).
• Analyzing the cost-effectiveness, affordability, and budget impact of health benefit offerings and recommending optimizations to maintain sustainability.
• Collaborating with the Benefit Package & Tariffs Advisory Panel to ensure transparent and inclusive design, review, and implementation processes for benefits packages and tariffs through stakeholder engagement.
• Overseeing effective implementation and continuous improvement of Benefits and Tariffs management information systems, ensuring they support efficient operations and member satisfaction.
• Providing guidance in collecting and analyzing data for purposes of health Benefits management in collaboration with other departments.
• Ensuring preparation of reports on Benefits Management.
• Establishing, implementing, and reviewing robust internal controls to safeguard the sustainability, affordability, and integrity of benefits packages for all stakeholders.
• Ensuring effective collaboration with external stakeholders.
• Ensuring compliance with local and international standards in Benefits Management (as prescribed in the Act), fostering alignment with globally recognized best practices and enhancing the Authority’s reputation.
• Overseeing development and execution of policies and strategies for business process re-engineering, driving innovation and efficiency in Benefits Management.
• Overseeing provision of expert guidance in Benefits management on reviewing and amending the Social Health Insurance Act, ensuring responsiveness to the evolving healthcare landscape and adherence to quality standards.