Director: Provider Payment Mechanism and Rates at National Department of Health

REQUIREMENTS :

• Grade 12 certificate and an undergraduate qualification (NQF level 7) as recognized by SAQA in Finance/Accounting, Cost Accounting, Economics, Health Economics, or Actuarial Sciences.
• A postgraduate qualification (NQF level 8) in relevant disciplines such as Finance and Accounting, Cost Accounting, Health Economics, Actuarial Sciences or a related quantitative social sciences field would be an advantage. At least five (5) years’ experience at a middle/senior managerial level in Health Economics/ Accounting within the health sector.

DUTIES :

• Review the existing data collection and reporting process in health care facilities; the flow of funds; identify changes needed to move from input-based payment to prospective payment (e.g. Capitation and Diagnosis Related Groupers).
• Develop an approach to on-going revisions of provider payment systems, and develop proof-of-concept, and progressively implement new provider payment mechanisms. Determine the nature of provider payment mechanisms and adopt additional mechanisms, including capitation for PHC and DRG for hospitals.
• Define cost modelling methodology and required data sets and develop costing manual and determine the prices of health care services/drugs/consumables to be paid by the NHI Fund based on developed costing manual. Prepare information and communicate to the public (users, providers and other stakeholders) on the prices of services/drugs/consumables included in the Health Care Benefits to be covered by the NHI Fund.