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Manager Research And Actuarial Services

NHIMA | Lusaka

NHIMA

Innovating the future of tech solutions in Zambia.

Job Description

Key Responsibilities

  1. Position Summary

Reporting to the Director of Research, Planning & Strategy, the Research and Actuarial Services Manager will be responsible for managing NHIMA’s research and actuarial services. The role involves providing research (primary and secondary) and lead on actuarial analysis for the National Health Insurance Scheme (NHIS) for the evaluation of the scheme’s financial liability position, risks, population, labour, and market dynamics to ensure scheme viability in line with the NHI Act No 2 of 2018, and the achievement of Universal Health Coverage.

The Manager will advise and lead in the design and maintenance of actuarial models and systems for the accurate and timely collection and analysis of the NHIS data. S/he will work closely with the Health Insurance Services and Information Technology team to provide integrated health insurance data systems development support and drive improvements to deliver results. The role will work directly with the M & E counterpart on the design, execution, and review of actuarial activities to monitor and assess the scheme viability. Furthermore, the position will support the coordination of strategic planning in addition to the development of a robust monitoring and evaluation regime in NHIMA.

  1. Key Overall Responsibilities

Among others, the role of the Research and Actuarial Manager will include the following core activities: 1) Development and implementation of the NHIS actuarial models for data collection tools, processing and management; 2) conduct routine and non-routine data analysis of aggregated facility and patient level health utilization and cost of health access data; 3) oversee data cleaning, quality control, and assembly and organization of datasets for implementation and actuarial analysis; 4) propose innovative approaches to enhancing the effective performance of the NHIS; and 5) conduct annual in-house actuarial reviews of the NHIS to ascertain scheme viability.

  1. Specific Responsibilities:

  1. Research and Actuarial Services

  1. Lead the development of Research and Actuarial tools and materials including to guide actuarial research, planning and implementation across NHIMA.
  2. Lead the development, bench-testing, coordination, and maintenance of the design of data collection, quality control, data transfer, data management, and report generation on the implementation of the National Health Insurance Scheme (NHIS) including quality assurance and data integrity.
  3. In collaboration with the Director of Research, Planning & Strategy, conduct a detailed review of the NHIMA Actuarial Assessments, identifying the significant recommendations and complexities of the NHIS that require follow-up for the successful implementation of the scheme.
  4. Provide actuarial input in the NHIS Benefits Package design and assessment of contributory rates for the NHIS and provide management with actuarial valuations of the impact of any proposed NHIS benefit changes or new product designs on an as-needed basis.
  5. With the investment team, help in the monitoring and analysis of experience investigations (claims, expenses etc.) and other actuarial investigations for the NHIS by estimating and forecasting claims/loss experiences for purposes of estimating reserves and ensuring viability of the scheme.
  6. Provide reports for the purpose of evaluating and advising management on the financial impact of proposed provider agreements or changes to existing agreements on an as-needed basis.
  7. Advise NHIMA senior management on the financial impact of any special pricing or contract arrangements which may affect NHIS financial viability though prudential identification and quantification of financial risk within and across the NHIS.
  8. Monitor incoming data on NHIS utilization; develop, run, and maintain quality assurance code sand generate queries, when needed and maintain an audit trail for data cleaning including advise on data storage, version control, and archiving practices.
  9. Initiate and lead larger data quality and cleaning activities within and across activities of the NHIS, including tracking key indicators on Universal Health Coverage.
  10. Develop and present dissemination materials, such as abstracts, posters, reports, and PowerPoint presentations on the NHIS.

Education Requirements

Education:

  1. Must have Grade twelve (12) School certificate with 5 ‘O’ levels with credit or better including Mathematics and English Language.
  2. Must have a bachelor’s degree in economics, actuarial science, demography, mathematics, statistics, or related field.
  3. A postgraduate qualification in economics, actuarial science, demography, statistics, data science or related field.

Experience:

  1. Minimum 5 years of experience in applied research, actuarial valuation, health systems policy/health financing policy or Security (insurance or pensions) in Zambia or internationally.
  2. Hands-on experience in planning and management, with strong experience in statistical analyses alongside strong statistical skills in Stata, R, or similar software in addition to possessing excellent skills in Excel spreadsheet development and maintenance.
  3. Demonstrated ability to problem-solve complex issues using strong analytical skills and proactively anticipate work requirements with minimal supervision.
  4. Understanding of National Health Insurance Systems, with experience of working for national or international organizations in health systems strengthening/or healthcare financing/pensions, and a deep understanding the Zambian healthcare system and healthcare financing policy and Universal Health Coverage.

Excellent oral and written communication skills and management experience required

Required Skills

  1. Participate in and advise on strategic initiatives in the NHIS on the enhancement of access to universal health coverage such as benefits package design, costing and scheme viability assessment based on data generated from a robust M & E system.
  2. Support the development and evaluation of the NHIMA Strategic plan to align it to the National Health Strategic Plan.
  3. Support capacity building in NHIS systems development with NHIMA stakeholders and service providers.
  4. Participate in knowledge dissemination events on NHIS to enhance public knowledge on the operations of the NHIS.
  5. Other functions as may be directed by the Director Research, Planning & Strategy.

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