Benefits Management Officers at The Social Health Authority

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To enhance institutional capacity and deliver on its mandate, SHA Board seeks to recruit visionary, result-driven, and experienced professional for the following positions;

BENEFITS MANAGEMENT OFFICER II | SHA/223/2025

Job Term: Permanent and Pensionable

Position Level: SHA 8

Number of positions: 4

Qualifications, Skills and Experience Required:

For appointment to this grade, an candidate must have:

  1. Bachelor’s degree in any of the following disciplines: Pharmacy, Health Financing, Health Economics, Actuarial Sciences, Statistics, Nursing, Mathematics, Dentistry, or its equivalent from a recognized institution.
  2. Membership with a relevant professional body, where applicable and in good standing;
  3. Proficiency in Computer applications.
  4. Shown merit and ability as reflected in work performance and results

Responsibilities:

You will assist in implementing the operational plan for Health Benefits management, including risk assessments, strategic purchasing of benefit packages, and analysis of cost-effectiveness.

This is the entry and training grade for this cadre. An officer at this level will work under the guidance of a senior officer.

Duties and responsibilities will entail: –

  • Supporting operational planning for Health Benefits management, risk assessments and monitoring performance against strategic objectives in collaboration with other departments.
  • Assisting Formulation and implementation of policies and strategies for effective and efficient Health Benefits management in collaboration with other departments.
  • Supporting the strategic purchasing of prescribed benefit packages in close collaboration with the Directorate of Fund Management and other departments ensuring efficiency, equity, and cost-effectiveness in service delivery.
  • Assisting in collaborations with the health Benefits Package & Tariffs Advisory Panel in evidence-based designing, reviewing, and updating of Benefit packages and Tariffs.
  • Implementing of the prescribed Benefits packages and Tariffs under the Primary Healthcare Fund for level 2, 3 and select 4 providers and facilities; under the Social Health Insurance Fund in level 4, 5 and 6 providers and facilities and the Emergency, Chronic and Critical Illness Fund in level 2-6 facilities and providers.
  • Participating in Analysing the cost-effectiveness, affordability, budget impact of health benefit offerings and recommend optimizations to maintain sustainability.
  • Supporting collaborations with the Benefit Package & Tariffs Advisory Panel, to ensure the benefits packages and tariffs design, review and implementation processes are transparent and inclusive through stakeholder engagement.
  • Participating in the effective implementation and continuous improvement of Benefits and Tariffs management information systems, ensuring they support efficient operations and member satisfaction.
  • Collecting and analysing data for purposes of claim management in collaboration with other departments.
  • Analysing the cost-effectiveness of benefit offerings and recommend optimizations to maintain sustainability.
  • Supporting the provision of expert guidance in Benefits management on reviewing and amending the Social Health Insurance Act, ensuring responsiveness to the evolving healthcare landscape and adherence to quality standards.
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