Medical Consultants, SHA

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

JOB DESCRIPTION

Medical Consultants (MC),

State Health Agencies (SHAs), MoHFW, GoI

 

1. POSITIONS VACANT: Medical Consultants (MC), State Health Agencies (SHAs), MoHFW, GoI (Five vacancies)

 

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 the SHA in implementing PM-JAY through the Consultants placed as above, who shall be tasked with the responsibility of strengthening existing PM-JAY institutional structures, in the State.

 

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

 

3. JOB DESCRIPTION/ RESPONSIBILITIES:

 

The Medical Consultants (MC) will coordinate all activities along with the designated official of the concerned SHA (Jharkhand, Jammu and Kashmir, Uttar Pradesh and Bihar). S/he will be responsible for supporting the empanelment of hospitals, medical and claims audit and prevention of fraud and abuse, along with the overall management and standardisation of processes, compliance with guidelines, etc.
 

Key Responsibilities:

(1) Study and acquire an in-depth understanding of PM-JAY processes, scheme guidelines and the role of various stakeholders;

(2) Support SHA in assessing whether processes adopted in the state for empanelment/ de-empanelment of hospitals, are as per PM-JAY guidelines;

(3) Provide support for the review of medical packages, suggesting revisions to existing medical packages, based on analysis of claims being made in the state;

(4) Support the preparation of evidence-based, standard treatment guidelines, adapting/ adopting international guidelines available. Also provide support for the conduct of systematic reviews for the preparation of guidelines;

(5) Conduct claims audit to prevent the occurrence of frauds/ abuse, as well as provide assistance in performing audits of the scheme, whenever necessary;

(6) Support SHA in assisting the state in identifying and managing frauds, devising mechanisms and systems to prevent, detect and control the frauds;

(7) Undertake new initiatives and projects under PM-JAY;

(8) Prepare technical reports, data analysis, new proposals and assessment reports;

(9) Any other assignment/ responsibility assigned by SHA.
 

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:

Minimum 3-5 years of experience of working in large-scale, government health insurance schemes, or the health insurance sector, in managing claims, hospital empanelment, medical audit of hospitals, and delivery of quality health services etc.;

 

Skills and Competencies:

(1) Sound knowledge of the health insurance/ public health sector;

(2) Strong analytical, interpersonal skills and strategic thinking capabilities;

(3) Excellent oral and written communication skills, sound comprehension and presentation skills in English and Hindi;

(4) Knowledge of common software packages like MS-Office (Word, Excel, PowerPoint);

(5) Ability to work under pressure with tight deadlines and attend to any ad hoc function, as may be required;

(6) Demonstrated ability to work in a multi-disciplinary team;

(7) Self-driven with the ability to work independently, when required.

 

5. VACANCY DETAILS: Five vacancies

           

6. COMPENSATION OFFERED:

 

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

 

7. LOCATION: SHA Office in concerned state.

 

S. No.

State

Number of Posts

1

Jharkhand

1

2

Jammu and Kashmir

1

3

Uttar Pradesh

1

4

Bihar

2

Total Number of Posts

5

 

 

 

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 SHA.

(Contract for Vacancies based in Bihar shall be till March, 2021.)

9. REFERENCE: MC-SHA

 

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.