Senior Medical Consultant (SMC)/ Medical Consultants (MC), NHA

  • GiZ
  • Job Reference Code: SMC-MC-NHA
Last date of application
 08-Dec-20 23:59 HR

JOB DESCRIPTION
Senior Medical Consultant/ Medical Consultant
National Health Authority (NHA), MoHFW, GoI

1. POSITIONS VACANT: Senior Medical Consultant (SMC)/ Medical Consultants (MC), National Health Authority (NHA), MoHFW, GoI, New Delhi

2. ORGANIZATION BACKGROUND:

The Ministry of Health and Family Welfare (MoHFW) has set up the National Health Authority (NHA) to manage the Pradhan Mantri – Jan Arogya Yojana (PM-JAY) at the national level. At the state level, implementation of PM-JAY is being facilitated by multiple State Health Agencies (SHAs), that have been especially established for the purpose.

MoHFW/ NHA has initiated the ‘Professional Programme for Health Protection,’ in partnership with GIZ, to enhance the capacities of the different implementing agencies that are helping manage PM-JAY. The programme is helping select, train and mentor consultants, who shall be placed at the NHA and/or different SHAs, to support implementation of PM-JAY.

Objective of the Assignment:
The objective of the assignment is to support NHA in implementing PM-JAY by strengthening existing institutional structures at the national level. It is accordingly proposed to hire a medical professional positioned at New Delhi, to support the NHA various activities including reviewing guidelines issued by the Authority, coordinating with different SHAs and providing support for Hospital Network Management.

For more information about NHA, please visit https://pmjay.gov.in/about/nha

3. JOB DESCRIPTION/ RESPONSIBILITIES:

The Medical Consultant (MC) will coordinate all activities with the designated official of the NHA, New Delhi. S/he will be responsible for providing support for the empanelment of hospitals, medical audit, prevention of fraud and abuse, claims audit etc, along with matters relating to the overall management and standardisation of processes and compliance with guidelines.

Key Responsibilities:
(1) Study and acquire in-depth understanding of PM-JAY processes and scheme guidelines and the role of various stakeholders;
(2) Support NHA in assessing processes adopted by the states for the empanelment/ de-empanelment of hospitals with reference to guidelines suggested by PM-JAY;
(3) Provide support for the analysis of medical packages, suggesting revisions to existing medical packages based on claims received against them by the states;
(4) Provide support for the preparation of evidence-based standard treatment guidelines, adapting/ adopting international guidelines and for the conduct of systematic reviews for preparing the guidelines;
(5) Conduct of audit of claims received to prevent the occurrence of fraud/ abuse;
(6) Support NHA in assisting the states in the identification and management of frauds, helping in devising mechanisms and systems to prevent, detect and control the same;
(7) Provide assistance for performing audits of the scheme, whenever necessary;
(8) Undertake new initiatives and projects under PM-JAY;
(9) Analyse data and prepare technical reports, new proposals and assessment reports;
(10) Any other assignment/ responsibility assigned by NHA.

 

4. QUALIFICATION, SKILLS AND EXPERIENCE: 
     

Qualifications:

Essential:
MBBS degree from a recognized institute/ university.

Desirable:
Post-graduation or higher qualification in the field of Public Health, or Community Heath, or Health Management, from a recognized university or institute.

Experience:

Essential:
Senior Medical Consultant:
(1) 10-15 years of experience of working as a clinician, along with 4-5 years of supporting large-scale government health insurance schemes or health insurance sector in managing claims, hospital empanelment, medical audit of hospitals, checking the quality of delivery of health services, etc.

Medical Consultant:
(1) Minimum 4-6 years of experience of working in large-scale government health insurance schemes or health insurance sector, in managing claims, hospital empanelment, medical audit of hospitals, checking the quality of delivery of health services, etc.;

Skills and Competencies:
(1) Sound knowledge of the health insurance / public health sector;
(2) Analytical skills and strategic thinking;
(3) Demonstrated ability to work in a multi-disciplinary team;
(4) Knowledge of commonly used software packages like MS Word, Excel and PowerPoint;
(5) Ability to work under pressure and attend to any ad hoc functions, as necessary;
(6) Self-driven and able to work with tight deadlines;
(7) Excellent communication and presentation skills, sound comprehension, strong analytical and interpersonal abilities;
(8) Ability to work independently when required;
(9) Excellent oral and written communication skills in English and Hindi.

5. VACANCY DETAILS: Two vacancies (One for Senior Medical Consultant and one for Medical Consultant)\          

6. COMPENSATION OFFERED:

The offer made to the selected candidate shall be commensurate with qualifications, experience, and salary history.

7. LOCATION: NHA Office, New Delhi

8. CONTRACT TYPE AND PERIOD:

The post-holder shall be engaged on a consultancy contract, initially for a period of 12 months, extendable thereafter, on the basis of performance and approval by NHA.

9. REFERENCE: SMC-MC-NHA

10. CONTACT INFORMATION:

Team SAMS
Strategic Alliance Management Services P Ltd.
1/1B, Choudhary Hetram House, Bharat Nagar
New Friends Colony, New Delhi 110 025
Phone Nos.: 011-41011564/65; 4081 9900

 

11. LAST DATE FOR APPLICATIONS:
Eligible candidates interested in the position are requested to apply using the link https://recruitment.samshrm.com/Jobs/GIZ  by or before December 8, 2020.