Technical Advisor, Health Insurance Analytics

Clinton Health Access Initiative

Experience
Education
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Responsibilities

Overview:

Founded in 2002 by President William J. Clinton, 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. Based on the premise that a business-oriented strategy can facilitate solutions to global health challenges, CHAI acts as a catalyst to mobilize new resources and optimize the impact of these resources to save lives, via improved organization of commodity markets and more effective local management. 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's teams are working side-by-side with more than 30 governments to tackle many of the largest barriers to effective health care.

 

CHAI Ethiopia is currently carrying out a wide range of programs to support the Ministry of Health in improving access to and increasing the quality of health services. As one of CHAI’s largest field offices with more than 150 staff, the Ethiopia office operates programs across hospital management; maternal, newborn and child health; HIV/AIDS; nutrition; vaccines; and health financing. 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.

 

Description:

The Government of Ethiopia is rolling out health insurance with the goal of reaching most of its population of 100 million people by 2020. The government is scaling up community-based health insurance for the informal sector, rolling out social health insurance for the formal sector, and harmonizing these two schemes under a national insurance scheme. This is one of the most ambitious health financing reforms on the continent, and if implemented well, has the potential to transform the health system and move the country closer to its goal of universal health coverage.

 

To successfully roll out this ambitious reform, the leadership of the newly formed Ethiopian Health Insurance Agency will need to overcome technical, operational and management challenges.  CHAI has been asked by senior leadership of the Ethiopian Health Insurance Agency to provide comprehensive support in testing innovations across pilot community based health insurance schemes,  to ensure health insurance can be sustainably brought to scale. This includes putting in place more efficient and effective management structures and information systems, new mechanisms pool or re-distribute resources across districts, new processes to better incentivize and hold providers accountable for efficient and high quality service delivery, and new policies and processes to enroll hard to reach populations.  Ethiopia will be a flagship program for CHAI’s work in health insurance, shaping our engagement in other countries.

Responsibilities:

CHAI is seeking a highly motivated individual with strong technical capabilities and relevant experience to play a key role in our engagement in insurance in Ethiopia.  The Technical Advisor will provide technical and analytical input to a large CHAI team. The technical advisor, through robust analytical work, will help inform policy changes in how insurance is pooled and used to re-distribute resources and purchase services. This will include generating and analyzing evidence, and then working with the government and international experts to align on a benefits package, to define premium rates, to revise the pooling strategy, and to improve provider payment mechanisms and rates. Decisions will be piloted in a sub-set of regions, iterated on, and then brought to national scale.

 

This role offers the opportunity to be involved in the development of one of the largest national financing reforms on the continent, furthering expertise in health financing, and building experience in managing complex technical projects, working closely with the Government of Ethiopia. This role will report to the Senior Technical Advisor on the CHAI Ethiopia Health Financing Team.

 

Key responsibilities include, but are not limited to, the following:

  • Work with the Ethiopian Health Insurance Agency and CHAI staff in areas ranging from benefits design, to member management, to provider management, to management information systems, to pooling and finance.
  • Support the design and implementation of research. This includes taking ownership of technical work streams within priority areas, including a health service costing.
  • Support analyses such as financial sustainability modeling to inform and iterate on premiums, subsidies, benefits and contribution rates.
  • Present research and analyses to stakeholders, working with the Health Insurance Agency to use this information to develop evidence-based strategies, policies and procedures beginning in two pilot regions.
  • Pilot, roll-out and continuously improve core business processes in two pilot regions; for example through the development of tools or reporting templates and advising on improved data management and analysis techniques.
  • Support capacity building initiatives for a team of CHAI staff working across different directorates of the Health Insurance Agency, providing technical input and formal training and day to day support.
  • Work with international and local external experts
  • Other responsibilities as assigned by manager

Qualifications:

CHAI works in a fast-paced, results-driven environment and this health insurance reform is a top priority for the government. This individual would need to have strong grasp of the theoretical foundations of health financing, combined with excellent applied quantitative skills, and relevant experience. Professional experience in health insurance, in either a developed or developing country context, is a significant advantage. The ability to generate technical output and translate findings into pragmatic policy recommendations will be central to the success of the technical advisor role. CHAI places great value on resourcefulness, responsibility, tenacity, flexibility, independence, energy, work ethic and humility.

 

Qualifications and advantages include the following:

  • Advanced degree (Masters or PhD) in a related field such as health economics, public health, financial management, public policy is strongly preferred; or Bachelor's degree minimum with exceptional experience
  • 7-10+ years of professional or experiential experience in demanding, results-oriented environments in either the public or private sector preferred; 5 years minimum professional experience
  • Experience working in health or life insurance in developed or developing countries would be a strong advantage. This could include, but is not limited to, specific experience in actuarial costing, benefits design, and provider contracting and payment mechanisms.
  • Experience working with government agencies in advantage;
  • Knowledge of the Ethiopian health system is an advantage;
  • Excellent problem solving, analytical and quantitative skills, including attention to detail;
  • Advanced data analytics skills including a high level of proficiency with Excel and experience in financial modeling;
  • Ability to work independently, set priorities and handle multiple tasks simultaneously;
  • Ability to learn on the job quickly and absorb and synthesize a broad range of information;
  • Ability to navigate ambiguous and complex processes and be flexible;
  • Strong communication skills, including delivery of compelling presentations and documents;
  • Strong command of the English language; and
  • Willingness to travel within Ethiopia as needed.
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Confirmed 12 hours ago. Posted 30+ days ago.

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