Organizational Background:Founded in 2002 by President William J. Clinton and Ira Magaziner, the Clinton Health Access Initiative (CHAI) is a global health organization committed to strengthening integrated health systems around the world and expanding access to care and treatment for HIV/AIDS, malaria and other illnesses. CHAI’s solution-oriented approach focuses on improving market dynamics for medicines and diagnostics; lowering prices for treatment; accelerating access to lifesaving technologies; and helping governments build the capacity required for delivering high-quality health services. CHAI does not operate stand-alone programs, nor does it build parallel health systems. Rather, CHAI works at the invitation and in support of governments.
CHAI is currently operating in Ethiopia carrying out a wide range of programs to support the Ministry of Health and Ethiopia Health Insurance Agency in improving access to and improving the quality of health services. As one of CHAI’s largest field offices with more than 160 staff, the Ethiopia Office operates programs across: maternal, newborn and child health; HIV/AIDS; Cancer; vaccines; Labs and health financing; Child Survival and HRH. The health financing program aims to transform how the health system is financed to substantially and sustainably increase access to services, beginning with essential services for those most in need.
Project Description
As part of its commitment to reducing the financial burden of accessing health services for the population, Ethiopia began piloting Community Based Health Insurance (CBHI) in 2010/11 in 13 woredas. To-date, this health insurance model has been rapidly scaled up by the government to 600 schemes (of which 360 are active), towards a 2020 target of reaching 80% of the eligible population in 80% of the woredas in the county. Despite the rapid proliferation of CBHI schemes across the country, the current model of CBHI faces specific challenges that need to be addressed before a full national scale-up is realized.
In partnership with the Ethiopian Health Insurance Agency (EHIA), CHAI is currently conducting a series of activities to diagnose these challenges. This diagnostic work will include the development of proposed solutions for addressing any identified challenges, gaps or policies or structures that need to be improved or reformed. These solutions will address challenges related to enrollment and revenue collection, pooling, purchasing benefits package and governance. The implementation of these solutions will be carried out jointly by EHIA and CHAI over the next two years.
To support the implementation of these solutions, CHAI is seeking a highly motivated individual with outstanding technical capabilities to provide technical assistance in health insurance scale-up at the federal and regional levels. This individual will be based in Provider Affairs and Quality Assurance Directorate of the EHIA headquarters office, reports to Director of Provider Affairs and Quality Assurance, and oversees the implementation of the solutions across multiple regions. He/she will coordinate with regional scale-up activities within the EHIA and across other government ministries or departments, where necessary.
Key Roles and Responsibilities:
- Support Provider affairs and quality assurance directorate of the Ethiopian Health Insurance Agency to design appropriate health insurance benefit package, contract management, quality assurance and claim management systems
- Support assessment, contracting and contract monitoring and management of public and private health care providers
- Conduct periodic assessment on health facility readiness and health service quality assurance, and propose policy recommendations
- Develop and roll out clinical auditing and quality assurance mechanisms
- Support revision and refining of provider payment mechanisms and reimbursement rates
- Support development and revision of insurance claims forms and claims management processes
- Develop evidence based provider management strategies, policies and procedures for the Ethiopian Health Insurance Agency
- Support revision of CBHI and SHI benefit packages
- Review and develop standardized operating procedures and tools required for the effective implementation contract and claim management
- Set up internal systems to facilitate monitoring, evaluation and early identification of problems and work with team members to respond to the challenges
- Review and develop guidelines, manuals, legal frameworks, standardized operating procedures and tools required for effective implementation health insurance at all levels
- Produce standardized health care provider training materials and support to provision of training at all levels
- Collaborate with other directorates to revise benefit packages, membership management automation systems
- Compile reports and updates on implementation progress and routinely provide updates to the Steering Committee
- Build process management and technical capacity within the Health Insurance Agency at head quarter and branch offices
- Serve as a liaison from EHIA HQ to the regional CBHI stakeholders, other implementation leaders and the CHAI Team
- Support in the development of TOR and subsequent processes in hiring of staff and procurement of infrastructure based on gap analysis and road maps
- Conduct day to day capacity building and training for Health Insurance Agency staff
- Support documentation of best practices and designing of scale up strategies
- Carry out additional responsibilities as requested by supervisor.
Job Requirements
Qualifications
CHAI seeks results-driven, highly motivated individuals who are fast learners, detail oriented and have the ability to adapt to dynamic and demanding work environment. CHAI places great value on resourcefulness, responsibility, tenacity, flexibility, independence, energy, work ethic and humility.
Qualifications include the following:
- Master’s Degree in health care, pharmacy, nursing or public health preferred.
- At least 10 years of relevant experience of which five years is in managerial position and five years in health insurance or health financing program implementation
- Experience in designing, managing and implementing health service quality assurance system and clinical auditing
- Strong interpersonal skills and ability to achieve consensus amongst stakeholders
- Excellent in problem solving and analytical skills, including attention to details
- Strong organizational skills with ability to handle multiple tasks simultaneously in a fast-oriented environment
- Ability to learn the job quickly through research and absorb synthesis a broad range of interventions
- Experience designing, managing and implementing community development projects,
- Ability to navigate ambiguous and complex processes and adhere to government or EHIA integrity and institutional standards and procedures
- Strong interpersonal skills and ability to build relationships including with other staff in other directorates and EHIA branches
- Strong communication skills, including delivery of compelling presentations and documents in Microsoft PowerPoint and Word
- Strong command of the English language and Amharic required
- Experience in the public and / or health insurance sector is an advantage
- Willingness to travel outside of Addis Ababa when deemed necessary.
- Female applicants are encouraged to apply
How to Apply
More Information
- Job City Addis Ababa