Consultants - Monitoring and Evaluation, SHA

  • GiZ
  • Job Reference Code: C-M&E-SHA
Last date of application
 08-Dec-20 23:59 HR

JOB DESCRIPTION

Consultants - Monitoring and Evaluation (C-M&E),

State Health Agencies (SHAs), MoHFW, GoI

 

1. POSITIONS VACANT: Consultants – Monitoring and Evaluation, (C-M&E), State Health Agencies (SHAs), MoHFW, GoI, (Three Vacancies)

 

2. ORGANIZATION BACKGROUND:

 

MoHFW has set up National Health Authority (NHA) to manage PM-JAY and at the state 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 SHAs 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 Consultants - Monitoring and Evaluation (C-M&E) will coordinate all activities with the designated official of the SHA. S/he will assist the SHA by providing insurance specific domain knowledge for standardizing the monitoring and evaluation process. The SHA will require C-M&E services for managing core aspects of health insurance outcomes viz. claims management, grievances, service provider management, fraud and abuse control, etc.
 

Key Responsibilities:

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

(2) Continuously track the progress of PM-JAY implementation in the state by using various indicators and analyzing and evaluating available enrolment and claims data of the scheme;

(3) Develop indicators and templates for reports/ dashboards/ scorecards, as per the requirements of the state and PM-JAY guidelines;

(4) Aid SHA in tracking timely settlement of claims by insurance company/ TPA and the progress of grievance redressal mechanism;

(5) Analyse reasons for claim rejections and suggest corrective measures;

(6) Prevent fraud and abuse of the scheme by beneficiaries and hospitals by using the available claims data;

(7) Ensure that Insurance Companies, TPAs and Empaneled Hospitals adhere to prescribed guidelines for service delivery and claims payments;

(8) Compile reports for different stakeholders, based on data analysis using statistical tools. Also, prepare and submit periodic reports to the SHA for the review of the scheme;

(9) Provide training to state and district level officers on various aspects of data reporting formats, reports and utilization of data, as and when required by the SHA;

(10) Coordinate/ liaise with state officials, development and technology partners, stakeholders and functionaries, while supervising implementation of PM-JAY and/or other health insurance scheme;

(11) Assist SHA in the convergence of PM-JAY with other health schemes;

(13) Prepare various reports and documents for PM-JAY, as per the needs of MoHFW/ NHA and GIZ;

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

4. QUALIFICATION, SKILLS AND EXPERIENCE: 
     

Qualifications:

 

Essential:

Postgraduate degree/ diploma in Statistics, or Management, or Economics, or Demography, or Health Management, or equivalent quantitative discipline from a recognized institute/ university.

 

Desirable:

Diploma/ certificate course in IT.


Experience:

 

Essential:

Minimum 5-8 years of relevant, professional, experience in monitoring and evaluation of large government projects/ social sector projects.

 

Desirable:

(1) Experience of working with a large government health insurance programme or health insurance company or TPA, possessing familiarity with provider management, claims processing and customer services;

(2) Experience of working in a national /state level MIS system;

(3) Extensive experience of project management, including planning, execution and monitoring of large-scale government projects.

 

Skills and Competencies:

(1) Thorough knowledge of monitoring & evaluation, including data dissemination techniques, reporting and documentation;

(2) High degree of competency in using Windows-based computer programs and commonly used software packages like MS Office (Word, Excel, PowerPoint, etc.);

(3) Knowledge of qualitative and quantitative data analysis software;

(4) Experience of working with mobile, biometrics and other related technologies;

(5) Knowledge of insurance regulations, provider management and customer servicing;

(6) Excellent oral and written communication and presentation skills in English and Hindi, including sound comprehension, strong analytical and interpersonal abilities;

(7) Ability to work independently when required;

(8) Proven ability to work in a multi-disciplinary team.

 

5. VACANCY DETAILS: Three 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

Jammu and Kashmir

1

2

Uttarakhand

3

Haryana

1

Total Number of Posts

3

 

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.

 

9. REFERENCE: C-M&E-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.