Job Openings at National Hospital Insurance Fund (NHIF)

REF. NO. NHIF/DBPM/001/20

Reporting to the Chief Executive Officer, the successful candidate will be responsible for overall leadership and oversight in the implementation of sustainable operational strategies related to member registration and retention, revenue collections, benefits management, case management, claims processing, quality assurance and policies for enhancing increased accessibility and quality healthcare for NHIF members and declared dependents geared towards Universal Health Coverage (UHC).

JOB PROFILE

LEADERSHIP

• Lead the development, implementation, monitoring and review of sustainable operational strategies relating to member registration and retention, revenue collections, claims processing, case management and quality assurance;
• Lead stakeholder engagement activities that will enhance the achievement set targets in member registration, revenue collection, case management and claims processing;
• Oversee empanelment of health providers and ensure they are operating in line within the contracts and set industry and professional standards;
• Lead strategic purchasing initiatives
• Lead a team of professionals within the directorate
• STAKEHOLDER ENGAGEMENT
• Provide technical advice to the CEO and Board of Management on issues of compliance, member registration. claims administration. healthcare provider surveillance, beneficiary satisfaction, disease patterns and trends:
• Engage with the stakeholders in the Public. Private and Sponsored Programs Sectors to identify and optimize on membership registration opportunities:
• Engage county governments and other potential partners in ensuring that all respective county residents have insurance membership with NHIF:

HEALTHCARE SERVICES

• Develop, enhance, and implement diagnosis, procedure, and other classifications;
• Develop, pilot. and implement prospective provider payment mechanisms;
• Define cost modelling methodology and required data sets and develop costing manual;
• Determine the prices of health care services, drugs and consumables based on developed costing manual;
• Prepare and educate the public on the prices of services, drugs and consumables included in the Health Care Benefits;
• Determine the method of drugs prescribing and determine the way of issuing of drugs covered by NHIF.
• Refine referral guidelines;
• Propose functions and funding for specific health services to be added to the NHIF on an incremental basis;
• Participate in the Health Needs Assessment for clinical interventions, pharmaceuticals and technologies with other responsible bodies;
•  Compile the annual plan of needs for procurement of the Health Care Benefits;
• Participate in the Health technology assessment (H TA) for clinical interventions, pharmaceuticals and technologies with other responsible bodies;

CONTRACTING AND EMPANELMENT

• Develop and implement performance based contracting methodology, including performance indicators. quality indicators, contract monitoring and payment terms;
• Administer contracts ensuring efficient process of preparing, signing, reviewing, adjustment and payment based on performance reports;
• Define standard operating procedures for the implementation of performance-based contracting, including contract performance monitoring, performance verification, payments, sanctions. grievance redress and contract renewal and modification;
• Train NHIF service providers' staff in the procedure of contracting of service providers. monitoring contract performance, identifying challenges. performance-based payments. and costing.

CLAIMS MANAGEMENT

• Develop and implement policies and strategies for effective and efficient management of claims;
• Ensure both employer and individual member accounts are managed properly;
• Collect, analyze, monitor and control reports/invoices from contracted health facilities;

CUSTOMER CARE, CASE MANAGEMENT AND QUALITY ASSURANCE

• Manage the process of receiving and processing complaints from Beneficiaries;
• Oversee the operations of the call centre;
• Perform preauthorization of benefits, concurrent review of patients undergoing treatment and post hospitalization reviews.
• Perform Beneficiary's satisfaction surveys and undertake other diagnostic studies;
• Coordinate the production and dissemination of all monitoring and evaluation reports including statistical reports;
• Facilitate and undertake investigations of Beneficiary fraud and corruption.
• Facilitate investigations of Health Service Provider fraud and corruption.

POLICY DEVELOPMENT

• Develop and implement strategies that enhance membership registration, retention and revenue growth;
• Develop and implement policies on regional and branch network expansion that will ensure NHIF services are accessible across the country;
• Develop and implement policies and strategies for effective and efficient case management and clinical audits;
• Develop and implement policies and strategies on business process re-engineering;
• Develop and implement policies on minimum acceptable quality benefits by healthcare facilities;
• Develop and implement strategies for enhancing increased accessibility to healthcare facilities by NHIF members and their declared dependants; ICT
• Support development of Prospective provider reimbursement mechanisms in the operating ICT systems;
• Develop and implement medical procedure codes in the operating ICT systems; Key Competences
• A strategic thinker with problem-solving, analytical, innovative and creative skills
• Proactive
• Ability to develop networks, alliances and collaborate widely to build and maintain strategic relationships.
• Strong acumen to effectively manage multiple stakeholders with diverse interests.
• Demonstrable professional and personal integrity
• Ability to persuade others. build consensus and gain cooperation.
• Strong experience in managing and building staff capabilities.
• Strong communication and interpersonal skills

The Ideal candidates should possess the following:

• A Bachelor's with a Master's Degree in any of the following fields; Economics, Medicine. Business Administration, Pharmacy, or a relevant field from a recognized university.
• Professional certification in Quality Management. Insurance or any other relevant certification.
• Minimum twelve (12) years' relevant work experience, four (4) of which is in a senior managerial role. Experience in a Medical Insurance company will be an added advantage.
• Experienced in leading through coaching. mentoring a team of staff with a deep understanding of business operations in healthcare sector
• Ability to create and manage strong relationships with both internal and external customers

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REF NO. NHIF/DFS/002/20

Reporting to the Chief Executive Officer. the successful candidate will establish. maintain and provide leadership on sound financial management to include budget. investments and liabilities.

JOB PROFILE

LEADERSHIP AND ADVISORY

• Lead and develop a team of finance professionals within the finance directorate.
• Lead in the development and management of the ERP finance and accounting system
• Oversight general program activities inventory management. staff advances, cash and bank management.
• Provide technical advice to management and staff on financial compliance of statutory and legal requirements.
• Oversee the interpretation and implementation of government policies in accordance with the PFM Act
• Lead and coordinate tax returns to ensure compliances. information reporting and other statutory requirements and advise the CEO and the Board on effective strategies for minimizing tax liability:
• Interpret financial reports. statements. accounting records and advice the CEO on the significance of the same.
• Oversee timely preparation of annual work plans and budget estimates.
• Lead in presenting proposed budgets to the Board. Treasury Officials and Donor Agencies as appropriate.

FINANCIAL POLICIES AND SYSTEMS

• Develop and install effective financial management systems and procedures to improve financial reporting and accounting in collection of member contributions.
• Establish stringent expenditure control ensuring that budgetary allocations are not exceeded without justifiable cause:
• Develop and implement computerized financial information systems to include general ledger, job costing and fixed assets management register.

FINANCIAL MONITORING AND TRACKING

• Prepare financial statements and other reports to summarize current and projected financial position including healthcare providers' account reconciliations.
• Monitor and track the utilization of capital and operational expenditure against approved plans.
• Coordinate and monitor the NHIF's investment of surplus funds and implement effective strategies for managing working capital and expenditure programs:
• Manage the cash flow and funding for smooth operations.

Key Competences

• Risk Management skills to understand the source of risk, evaluate and their mitigation.
• Ability to assess and facilitate change
• Takes critical and methodical approach when problem solving
• Leads others. manages resources and delegates effectively
• Methodical approach to problem-solving.
• Business skills to understand business operations and ethical issues
• Strong interpersonal and communication
• Stakeholder management.

The ideal candidate should possess the following:

• A Bachelors with a Master's Degree in any of the following fields: Accounting. Business. Finance, or Economics from a recognized university:
• A CPA (K). or ACCA (UK). or CFA and a member in good standing of a professional body.
• Minimum twelve (12) years' relevant work experience. four (4) of which is in a managerial role.
• Experienced in leading through coaching. mentoring a team of staff with a deep understanding of business operations in healthcare sector
• Ability to create and manage strong relationships with both internal and external customers

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REF NO. NHIF/HHR/007/20

We   are   seeking a  personable, experienced transformative human resources business partner to   join    the   organization. In  this    position, you    will   primarily act   as   an   internal consultant for   NHIF management on   human resources matters. You should be a proactive communicator and change agent, someone who can successfully balance employee needs with business objectives to create integrated solutions. This position reports to the Director, Corporate Services.

JOB PROFILE

• Assess and anticipate human resources-related needs
• Coordinate talent sourcing, selection and    placement  to   ensure  NHIF has    a  pool    of   qualified human resource with the required competencies
• Oversee the implementation of a comprehensive and effective human resource management information system.
• Coordinate the implementation of the performance management system.
• Coordinate resolution of   employee grievances and    disciplinary cases, recommending appropriate action to   resolve problems  as  well  as  assisting  employees  to  find  satisfactory  solutions  to  personal  problems  through  counseling  services
• Conduct training needs analysis and    baseline attitude surveys to   design and    implement relevant training programs.
• Monitor training programs to ensure that training objectives are met
• Develop and    nurture partnerships through human resources to   bridge the    divide between management and employees
• Analyze HR data trends and metrics to inform business decisions
• Design innovative programs to   build morale, improve workplace relationships, and    boost productivity and    retention
• Ensure regulatory compliance with    labor legal    requirements pertinent to  the   day-to-day management of  employees; collaborate with the legal department when necessary
• Interpret human resources policy to CEO, Management and Staff.

Key Competences

• Business Acumen to   understand and    deal    with    a  business situation in   a  manner that    is  likely to   lead    to   a  good outcome.
• Organizational Development mindset
• Problem Solving Skills to find solutions to difficult or complex issues.
• Strategic Partner to contribute to the development of and the accomplishment of organization wide objectives.
• Trusted Advisor on various people related aspects
• Flexibility and adaptable to business requirements.

The ideal candidate should possess the following:

• A    holder of   a  Bachelor’s degree in   Human Resource Management or   any    other discipline from a  recognized institution.
• A    Master’s degree in  Human Resource Management, Organizational Development or   Business Administration from recognized institution is a strong advantage.
• A    Higher Diploma or   a  professional certification in  Human Resource Management such    as   CHRP (K),    SPHRi, PHRi or CIPD.
• Have relevant experience of nine (9) years, three (3) of which should be at managerial level.
• A member in good standing of The Institute of Human Resource Managemen

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REF. NO. NHIF/HLS/005/20

Reporting administratively to   the   CEO    and    to   the   Board on   corporation secretarial services, the   successful candidate will head the legal department and is responsible for the legal affairs of the entire corporation including provision of legal  counsel  to  the  board  of  directors,  chief  executive  officer  and  other  senior  management.  The  candidate  must  possess strong initiative, excellent management and leadership skills and strong business acumen.

JOB PROFILE

• Provide guidance on   the    proper application and    interpretation of   laws    and    regulations and    ensure adequacy of controls to mitigate legal and other risks that may arise
• Establish and maintain effective legal processes, systems and standardized documentation.  
• Lead the    provision of   legal advice to   the    Board, management and    staff, proffering solutions to   legal problems, constraints, risks, options, consequences and approaches;
• Ensure compliance with laws, rules and regulations by the Board and Management;
• Vet and draft legal documents including contracts and leases;
• Liaise with other government agencies and on legal matters affecting NHIF
• Render professional legal advice for any legal action to be initiated and/ or defending the interests of NHIF
• Monitor legal developments and trends in policies, bills, and serve as source of legal information. •  Review and provide of feedback on legal aspects of all Committees of the Board
• Ensure the Board and Management’s compliance with regulatory requirements.
• Preparing legal opinions, advisories and briefs on litigation matters where necessary.
• Organize and establish day-to-day management of  legal staff. 
• Provide performance guidance and coaching of the legal staff.
• Prepare and timely circulate Board minutes and Committee papers.

Key Competences

• Ability to   communicate and    function in   a  change oriented setting with good knowledge of   Public Sector management.
• Ability to   interact with    senior officials of   other state agencies, corporate and    government and    to   present legal advice on various management issues.
• Excellent verbal and written communication skills in English.
• Strong skills in drafting a variety of legal documents and communicating complex issues clearly and concisely
• Ability to review under strict deadlines long and complex transactions.
• Negotiating skills and    capacity to   work with other non-legal professionals to   develop innovative solutions to conflicting interests and positions;
• Demonstrated leadership capabilities, including ability to organize and manage human resources to attain goals.

The ideal candidate should possess the following:

• A holder of a Bachelor’s Degree in Law (LLB) from a recognized university.
• A Master’s degree is a strong added advantage.
• Possess a Diploma in Legal Practice from the Council of Legal Education in Kenya.
• A holder of CPS (K) certification and a member in good standing.
• An Advocate of the High Court of Kenya and member of LSK with a valid practicing certificate.
• A minimum of nine (9) years, with three (3) years at managerial level in a busy legal and/ or corporate board secretarial function in an organization of similar size as NHIF.

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 REF NO. NHIF/HSC/006/20

We    are   looking for   an   experienced and    motivated Head of   Supply Chain to   join    our    team. You    will    report to   the   CEO and  be  responsible  for  the  procurement  of  products,  services  and  goods  by  identifying  potential  supplier  sources,  screening them and negotiating favorable payment terms in compliance with the provisions of the Public Procurement and Asset Disposal Act 2015.

JOB PROFILE

• Negotiate with external vendors to secure advantageous terms
• Approve the ordering of necessary goods and services
• Finalize purchase details of orders and deliveries
• Examine and test existing contracts
• Collaborate with key    management persons to   ensure clarity of   the    specifications and    expectations of   the organization
• Perform risk management for supply contracts and agreements
• Keep detailed records, generate reports, and    develop presentations to   help    management understand the   logistics perspective.
• Build relationships within the Fund and with external parties, such as suppliers or distributors.
• Collaborate with others from diverse backgrounds in order to identify problems and find solutions.

Key Competences

• Excellent communication skills
• Supplier Relationship Management Skills
• Financial Acumen toapply  a  broad  understanding  of  financial  management  principals  to  ensure  decisions  are  fiscally responsible and based on procurement budget.•  Talented in negotiation and networking 
• Technology Skills to   embrace new    software and    tools on   a  daily basis and    prepared to   learn about and    implement new technology.
• Hands on   experience with    supply chain management software (such as  SAP    MM,    AP   Modules, SAP    Plant Maintenance, etc.)
• Strong  interpersonal and communication and time management  skills

The ideal candidate should possess the following:

• A    of  a  Bachelor’s Degree in  any    of  the   following fields; Procurement and    Supplies, Stores and    Inventory Management, Commerce, Economics, or any other relevant field from a recognized university;
• A Master’s degree is a strong  added advantage
• Possess a  post    graduate Certification in  Procurement/Supply Chain Management from Kenya Institute of   Supply Chain Management (KISM) and a member in good standing with a valid practicing certificate.
• Have relevant experience of not less than nine (9) years in Supply Chain three (3) years at managerial level.

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REF.NO. NHIF/DCS/004/20

Reporting to The CEO, the successful candidate is responsible for the direction and management of Corporate Services of NHIF and for ensuring the provision of high level systems and services for all administrative functions including human resources, building facilities, corporate communication and Branding and related support activities.

JOB PROFILE

LEADERSHIP AND GENERAL MANAGEMENT

• Provide positive and professional leadership to staff ensuring that the directorate delivers effective support to the activities of NHIF
• Contribute to the management of NHIF, as a member of the Senior Management team, by participating in the generation of new ideas and fresh approaches to how NHIF manages its business;
• Delegate appropriate responsibility for the provision of corporate services while retaining overall accountability for the delivery of those services;
• Provide advice and support to all directorates and departments within the remit of Corporate Services;

HUMAN CAPITAL DEVELOPMENT AND MANAGEMENT

• Oversee the human resources function, ensuring the provision of advice on HR matters to the CEO and Senior Management team, including the development and review of relevant HR strategies, policies and procedures;
• Provide overall leadership in organizational development, talent sourcing and staffing, employment law, performance management, employee relations, and compensation and benefits.
• Provide leadership and direction to the HR staff fulfilling the role of senior level advisor to Management executives and employees on human resources trends.
• Develop and implement a NHIF human resources business plan, establishing accountability, identifying solutions to resolve problems and fostering a diverse workplace.
• Establish short- and long-term goals, budgeting for HR expenses, and networking with outside peers and organizations when needed to achieve goals.
• Lead the development of an occupational health and safety (OHS) system that is consistent with local and international standards;

FACILITIES AND SECURITY MANAGEMENT

• Manage the premises, facilities used by NHIF including the relationships with landlords, managing agents and other tenants where appropriate.
• Procure and manage a range of facilities management services including catering, cleaning, security, and fire protection.
• Develop, maintain and oversee property management, acquisition, disposal and rationalization strategy;
• Oversee the provision of administrative and logistical support services.
• Direct maintenance and security of the NHIF’s infrastructural equipment, machinery and facilities.

POLICY FORMULATION AND IMPLEMENTATION

• Constantly review the corporate services’ policies and procedures and oversee the enforcement of statutory regulations.
• Oversee the integration of corporate plans and programs in accordance with Government guidelines, priorities and the NHIF’s mission;
• Lead in the effective communication of corporate strategies, policies and procedures.
• Lead the development and continuous revision of standard operating procedures (SOPs)

COMMUNICATION AND BRANDING

• Oversee development of a strategic Integrated Marketing and Communication plan.
• Ensure the IMC plan reflects consistent messaging and supports the Fund’s business and communication goals
• Oversee development of stakeholder collaterals
• Ensure executive management team is apprised of communication issues at all times.

Key Competences

• Proven track record of meeting ethical and confidentiality guidelines.
• Excellent organizational skills and efficiency;
• Experience managing and communicating organizational change.
• Relevant work experience developing effective programs to support the initiatives of a complex and large organization
• Proven track record of achieving results with demonstrated success in developing policies, procedures and processes and building systems and tools to support a transformation
• Experience in implementing significant change management processes;

The ideal candidate should possess the following:

• Be a holder of a Bachelor’s Degree in any of the following fields; Human Resources Management, Business Administration, Economics, Organization Development or any other relevant field from a recognized university;
• A Master’s Degree in any of the above, or related fields from a recognized university in Kenya.
• Possess a Professional Qualification in Human Resource Management, Communication, general administration and be a member in good standing of a Human Resource Professional Body.
• Have relevant experience of not less than 12 years in HRM, Business Administration, Communication and general Management with four (4) years at senior management level in an organization of similar size and complexity as NHIF.

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REF. NO. NHIF/DICT/003/20

Reporting to the CEO. the successful candidate will provide strategic corporate Information and Communication Technology services including selection, acquisition, development and installation of all ICT systems applications and infrastructure.

JOB PROFILE

LEADERSHIP

• Lead, direct and oversee ICT function and ensure continuous operation and cost-efficiency of the ERP information systems, data analytics systems, networks, database and data security systems.
• Develop and implement NHIF's ICT strategy in consultation with the Board, CEO and other directorates;
• Lead the development and implementation of the Information Systems & Security and Infrastructure and Services departments' strategic and operational plans and performance measurement that promotes accountability and success;
• Lead and promote a strong internal ICT customer service culture, ensuring a service delivery approach that is responsive to the operational and strategic needs of the NHIF;
• Oversee the development, implementation, coordination and the preparation of strategic procurement plans and tender specifications for purchasing capital equipment. goods and services as provided in the annual budget of the Directorate of ICT.

INFRASTRUCTURE DESIGN AND SUPPORT

• Supervise the management of planning. development, deployment, operations and maintenance of IT based information systems in NHIF. including the branches:
• Supervise the management of secure NHIF ICT enterprise infrastructure and services:
• Guide and coordinate all ICT projects related to selection. acquisition, development and installation of major information systems for NHIF while managing all ICT vendor relationships:
• development and implementation of systems for data analytics, data quality assurance and accountability for data management and use:

POLICY DEVELOPMENT AND IMPLEMENTATION AND INNOVATION

• Oversee development and implementation of ICT policies;
• Develop, manage and monitor the ICT budgets and policy guidelines
• Seek for innovative, integrated. reliable and sustainable technology services.
• promote a culture of continuous Improvement and business excellence, recognizing achievement and innovation;

STAKEHOLDER ENGAGEMENT

• Coordinate the development and implementation of systems for data analytics, data quality assurance and accountability for data management and use:
• Implement and educate on cost effective. best practice and sustainable CT capability for internal and external stakeholders including Scheme members and healthcare providers:
• Oversee coordination of ICT needs with other NHIF directorates, branch offices and external institutions to support planning and development of information systems:
• Build a sustainable positive working environment within the Directorate for ICT

Key Competences

• Critical Thinking and Problem Solving.
• Strong Communication and interpersonal skills.
• Ability to collaborate and make individual contributions on an unprecedented scale.
• Ability to adapt to rapid changes without losing focus on the strategic goal.
• Ability to establish and lead a team to achieve a common goal.
• Strong work and professional ethic and integrity.
• Manage strong relationships with both internal and external customers

The ideal candidate should possess the following:

• A Bachelors with a Master's degree in any of the following: IT, Computer Science, Software Engineering. ICT Project Management. Computer Engineering or their equivalent from a recognized Institution.
• A holder of an ICT professional certification in either IT Management. Information Security, CISM. CEH. CompTIA Security or their equivalent.
• A member in good standing of an ICT Professional body.
• Minimum twelve (12) years' relevant work experience. four (4) of which is in a managerial role.
• Experienced in leading through coaching. mentoring staff with a deep understanding of business operations in healthcare sector