Principal Registration and Compliance Officer - 4 Posts at The Social Health Authority (SHA)

Qualifications, Skills and Experience Required:

• Cumulative service period of nine (9) years’ relevant work experience, three (3) of which should have been at the grade of Senior Registration and Compliance Officer or in a comparable position.
• Bachelor’s Degree in Commerce, Accounting, Business Administration, Finance or Economics, Business, Medicine, Social Science, or Pharmacy or an equivalent qualification from a recognized institution.
• Membership of the relevant professional body where applicable and in good standing.
• Certificate in Management course lasting not less than four (4) weeks from a recognized institution.
• Proficiency in computer applications.
• Shown merit and ability as reflected in work performance and results.

Responsibilities:

The Social Health Authority (SHA) is seeking a qualified and experienced individual to join our team as a Principal Registration and Compliance Officer. This role is crucial for ensuring the efficient and transparent registration of beneficiaries and compliance of health providers with the SHA Act and regulations.

Job Purpose: This cadre will be responsible for reviewing and processing the claims, performing provider and beneficiary satisfaction surveys, and undertaking other diagnostic studies, supporting adherence and public awareness on referral guidelines and empanelment of healthcare providers and ensuring they are operating in line with the set industry and professional standards.

Officers in this cadre may be deployed to any of the following functional areas:-

• Beneficiary Registration
• County Coordination

Key Duties and Responsibilities:

• Implementing the empanelment process for licensed health providers and facilities to ensure compliance with the SHA Act.
• Undertaking the registration of beneficiaries and ensuring the process is efficient and transparent.
• Conducting compliance audits on providers and beneficiaries.
• Monitoring operational activities for compliance with the SHA Act and providing recommendations.
• Implementing and reviewing operational strategies for member registration and public education.
• Assisting in the development and review of SHA policies related to business process re-engineering.
• Engaging with stakeholders to identify opportunities for membership registration.
• Collaborating with County Governments and partners to promote SHA membership.
• Facilitating stakeholder engagement activities to support member registration and revenue collection.
• Implementing performance-based contracting methodologies and monitoring contract performance.
• Preparing and disseminating monitoring and evaluation reports.
• Implementing clinical audit policies and strategies.
• Conducting health needs assessments and risk assessments to inform strategic planning.
• Participating in Health Needs Assessments for clinical interventions and technologies.
• Supporting the inclusion of drugs and consumables in the SHA positive list.
• Contributing to the revision of the provider payment system.