To improve health status through the prevention of illnesses and the promotion of healthy lifestyles and to consistently improve the healthcare delivery system by focusing on access, equity, efficiency, quality and sustainability.
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An undergraduate qualification (NQF level 7) as recognized by SAQA in Public Health, Economics or Actuarial Science. A postgraduate qualification (NQF level 8) in relevant discipline such as Health Economics, Actuaries Science, Implementation Science/Research, Biostatistics, Epidemiology, or a related quantitative social science field would be an advantage.
At least five (5) years’ experience at a middle/senior management level in health care benefits design. Expert knowledge of Excel and VBA (Visual Basic for Applications) experience. Intimate knowledge of health care benefits design, Health Needs Assessments, Health Technology Assessment and National Health Insurance. Knowledge of CPT coding, ICD-11 and other international Procedure and diagnosis coding systems and understanding of medical terminology.
Knowledge of other programs such as Python, R, and SQL will be an added advantage. Knowledge and understanding of Public Service Regulation, Public Service Act, Public Finance Management Act and National Health Act.
Good communication (verbal and written), problem solving, organizational, decision making, interpersonal, assertiveness, planning, customer service, team management and computer skills (MS Office packages). Self-motivated and ability to work independently. A valid driver’s license. SMS pre-entry Certificate is required for appointment finalization.
DUTIES :
Develop methodology for strategic and operational planning for defining the composition of the Health Care Benefits, including health needs assessment, risk assessments framework (including costs, cost-effectiveness), and monitoring and control of progress against strategic objectives, including defining the evidence-based comprehensive package of health services, medicines and consumables covered or specifically excluded from the Health Service Benefits.
Develop methodology for and facilitate Health Needs Assessments for clinical interventions, pharmaceuticals and technologies. Develop and integrate a policy that links referral and portability of access to services to the health care benefits design.
Develop methodology for, and facilitate, Health Technology Assessment (HTA) considerations for clinical interventions, pharmaceuticals and technologies including specific health services to be covered by the NHI Fund on an incremental basis and an approach to on-going revisions to the Health Care Benefits.
Prepare information to be communicated to the public on the list of Health Care Benefits for users.
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