Technical Advisor, Sustainable Health Financing
The Clinton Health Access Initiative, Inc. (CHAI) is a global health organization committed to saving lives and reducing the burden of disease in low-and middle-income countries, while strengthening the capabilities of governments and the private sector in those countries to create and sustain high-quality health systems that can succeed without our assistance. For more information, please visit: http://www.clintonhealthaccess.org
The Government of Rwanda strives to achieve Universal Health Coverage (UHC) by enabling equitable access to quality health services for their population as outlined in the Fourth Health Sector Strategic Plan (HSSP IV). This commitment is made against a backdrop of rising health care costs and uncertainty around the future availability of donor funding. Rwanda is often cited as an example for UHC in Sub-Saharan Africa, in part due to high rates of enrollment in the Mutuelle de santé or CBHI scheme and continuously seeks to reach sustainability and build on its past gains and existing successful strategies. Acknowledging this, the Government aims to employ effective, equitable, efficient and sustainable health care financing approaches and inform reforms of existing financing mechanisms including the national insurance scheme.
CHAI Rwanda's Sustainable Health Financing (SHF) program works on a day-to-day basis with Government leadership in the Ministry of Health (MoH) and the Rwanda Social Security Board (RSSB). The goal of our program is to support the Government to sustainably finance and improve the Mutuelle de santé or Community Based Health Insurance (CBHI) scheme, which covers the majority of the population for essential health services, and address key challenges in the health sector, towards the goal of UHC.
CHAI currently seeks a Technical Advisor to work with the Rwanda Social Security Board (RSSB) to think through and implement strategic reforms in the design, implementation and management of the Community Based Health Insurance (CBHI) Scheme to improve the sustainability of the scheme. This is a top government priority and the technical advisor will therefore be seconded to RSSB to work on a day to day basis with the Director of the CBHI scheme and will report technically to the Deputy Director General. He or she will build capacity within the RSSB to generate evidence through data analysis that informs key decisions and to make and revise key policy decisions and improve management. He or she will manage an associate working within the RSSB. The Technical Advisor will report administratively to the CHAI Health Financing Program Manager, taking programmatic direction from RSSB DDGB. This position offers a unique opportunity to work closely with government leadership on the government's priority agenda of Universal Health Coverage.
The Technical Advisor will be responsible for providing direct support to the Deputy Director General of the CBHI scheme at RSSB on her priorities which include (i) proactively managing the CBHI scheme, identifying financial and quality performance challenges in advance, and addressing these challenges, and (ii) specifically addressing financial viability by assessing scheme sustainability; improving and revising design decisions in the scheme, including how funds are raised and pooled, as well as the benefits package and provider payment mechanism; and improving efficiency in operations. As part of his or her responsibility the Technical Advisor will build up capacity within RSSB to use evidence to inform key decisions and management and to engage across Ministries of Government.
CHAI works in a fast-paced, results-driven environment, and the sustainability and success of the CBHI scheme is a high priority for the government, at the center of the government's health financing agenda towards UHC. We are seeking a highly-motivated individual who is a fast learner and who is both detail oriented and has the ability to ask the key questions or see the 'big picture'. CHAI places great value on resourcefulness, entrepreneurship, responsibility, tenacity, flexibility, independence, energy, work ethic and humility. In addition, the candidate must demonstrate excellent communications skills and display cultural sensitivity.
- Serve as a strategic thought partner for the leadership of RSSB, and specifically the Deputy Director General of the CBHI scheme. This includes providing input through discussions with leadership, policy memos and similar documents that is based on evidence generated from Rwanda and lessons learned from across countries.
- Provide day-to-day technical and strategic support to senior CBHI managers across directorates on design, roll-out and streamlining of critical processes of the CBHI as well as other reforms. This includes advising on and supporting prioritization of short-term interventions in light of limited resources. It also includes advising on long-term health financing strategic plans. Key decisions may include the following:
- Strategies to increase enrollment, re-enrollment and satisfaction with the scheme,
- Innovative options to mobilize and manage funds,
- Strategies to improve pooling of risks and funds, and
- Strategies to improve efficiency and effectiveness in the management of funds through strategic purchasing and improved administration.
- Support the assessment of sustainability of the scheme and key interventions to address sustainability, including addressing design and operational decisions above. This may include:
- Working with RSSB to engage with the Ministries of Finance and Health on the overall sustainability strategy,
- Support the set-up of a process to design and revise the benefits package for the CBHI schemes, as part of an overall sustainability work stream and in close coordination with external experts, and
- Support the design and piloting of a potential provider payment reform, together with designated experts and stakeholders. This may include assessing and changing provider contracting (public and private), tariff setting, and piloting a revised mechanism.
- Support streamlining of management and administration to improve efficiency:
- Elaborate on requirements for and support implementation of an automated system by RSSB in line with a longer term automation plan,
- Work with RSSB to assess and improve management structures and business processes currently in place, and
- Support RSSB to use this routine data to inform key decisions to improve operational efficiency and monitoring.
- Provide support to RSSB to both generate evidence and use evidence to inform decision making and management:
- Support RSSB directorates to use routine insurance data (claims, enrollment, finance data) to conduct analyses and present results and recommendations to senior management, in order to inform decisions that improve efficiency, effectiveness, and sustainability of the CBHI scheme. This includes developing and tracking key performance indicators and management dashboards for example. It will also include identifying and developing evidence-based interventions to improve both efficiency and quality of care.
- Build process management and technical capacity within RSSB, mainly through day to day support on deliverables for which CHAI and government are jointly accountable, as well as through formal training. This includes strengthening the capacity of CBHI managers to perform analyses and use evidence for decision making and support establishment and implementation of evidence-based appropriate change management structures and systems.
- Provide quality assurance of CHAI's work across the RSSB, drawing on insights from across country contexts. Develop technical capacity within the CHAI team of 4 people (with potential growth).
- Support RSSB in coordinating partners, and work with other partners at the direction of RSSB to coordinate on key areas such as sustainability and automation.
- Perform any other duties as assigned by the RSSB Deputy Director General of Benefits.
- Master's degree in a relevant field such as health economics, public health, public policy, finance, business, or significant experience working in a public or private health insurance scheme or on a public health financing reform;
- 5-10 years of experience in demanding, results-oriented environments in the public sector and/or private sector. Experience working at a strategic level on another Sub-Saharan African country on an insurance scheme or reform is highly preferred;
- Demonstrated experience working with high level government stakeholders and/or other senior stakeholders in consensus-building processes on major health systems reforms;
- Experience informing development of government strategy, policy, and operational plans, preferably in health or health systems is a plus;
- Experience designing and managing teams and long-term projects;
- Excellent problem solving, analytical, and quantitative skills, including attention to detail and experience in modeling using Microsoft Excel;
- Strong communication skills, including delivery of compelling presentations and documents in Microsoft PowerPoint and Word;
- Exceptional diplomacy and interpersonal skills, demonstrated ability to build strong professional relationships with a range of stakeholders in a challenging, multi-cultural environment;
- 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 work with humility and achieve results;
- Ability to mentor and lead teams in a fast-paced and changing environment;
- Strong command of the English language;
- Strong writer, facilitator and oral communicator
- Professional experience working with government authorities in developing countries, with experience in sub-Saharan Africa;
- Experience working in public health and with international organizations;
- Familiarity with a broad range of key global health issues, including health systems or health financing challenges in developing countries.
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