Medical Consultant (Three Vacancies)

  • GiZ
  • Job Reference Code: MC- SHA
Last date of application
 15-Apr-21 23:59 HR

JOB DESCRIPTION
Medical Consultant, State Health Agency (SHA), Uttar Pradesh and Bihar

1. POSITIONS VACANT: Medical Consultant, State Health Agency (SHA), Uttar Pradesh (One vacancy) and Bihar (Two vacancies)

2. ORGANIZATION BACKGROUND:

The Indo-German Universal Health Coverage Programme (IGUHCP) is part of Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, Germany’s enterprise for international cooperation. GIZ works with Indian ministries at the Centre and State Governments for implementation of bilateral cooperation projects.

MoHFW has set up National Health Authority (NHA) to manage PM-JAY and at the state level it will be implemented by State Health Agencies (SHAs), set up for this purpose.

In order to enhance the capacities of the state implementing agencies to manage PM-JAY, MoHFW/NHA in partnership with GIZ, has initiated the ‘Professional Programme for Health Protection’. The Programme will select, train and mentor consultants to be placed in the State Governments and the NHA to support the implementation of PM-JAY.

Objective of the Assignment:

The objective of the assignment is to support the State Health Agency in implementing Pradhan Mantri – Jan Arogya Yojana (PM-JAY). The consultant shall support the strengthening of existing institutional structures for PM-JAY at the State level.

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

3. JOB DESCRIPTION/ RESPONSIBILITIES:
The Medical Consultant will be responsible for providing support in claim adjudication processes, empanelment of hospitals, medical audit, prevention of frauds and abuse, and claims audit along with matters related to the overall management and standardisation of processes and compliance of guidelines.

Specific roles and responsibilities will include the following:
Specific tasks:

(1) Make himself/herself thoroughly familiar with the PM-JAY processes. To acquire an in-depth understanding of the guidelines of the scheme and role of various stakeholders;
(2) Support the SHA in assessing the processes adopted in the states for empanelment / de-empanelment of hospitals as per the empanelment / de-empanelment guidelines of PM-JAY;
(3) Support in analysis of medical packages, suggesting revisions in the existing medical packages based on the claims being made in the state;
(4) Support in preparing evidence based standard treatment guidelines, also adapting/adopting the International guidelines available or support in doing systematic reviews in order to prepare the guidelines;
(5) Conducting the audit of claims being made to prevent the occurrence of frauds/abuse;
(6) Support the SHA in assisting the states in managing and identification of frauds, help the states in devising mechanisms and systems to prevent, detect and control these frauds;
(7) To assist in performing audits of the scheme whenever necessary;
(8) To undertake new initiatives and projects under PM-JAY.

Documentation:
Preparation of technical reports, analysis of data, new proposals and assessment reports

4. QUALIFICATION, SKILLS AND EXPERIENCE:     
Qualifications:

(1) MBBS or BHMS/BAMS with relevant experience in Claims adjudication processes supporting private or government health insurance companies is essential;

(2) Post-graduation or higher qualification in field of Public health, community heath, health management, from a recognized university or institute is desired.

Experience:
(1) Atleast 3-5 years of relevant post qualification professional experience;
(2) Proven of working in large scale government health insurance schemes or government health programmes;
(3) Experience in sector of health insurance in managing claims, hospital empanelment, medical audit of hospitals and quality of delivery of health services.

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

5. VACANCY DETAILS: Three vacancies

S. No.

City, State

Number of Posts

1

Bihar

2

2

Uttar Pradesh

1

Total Number of Posts

3

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

7. NATURE OF ENGAGEMENT:
The Consultant Programme Management shall be hired on a consultancy contract through Strategic Alliance Management Services P Ltd. (SAMS), a respected HR Agency.

8. LOCATION: The Consultant will be placed in State Health Agency in Lucknow Uttar Pradesh and Patna, Bihar.

9. CONTRACT TYPE AND PERIOD:
The post-holder shall be engaged on a consultancy contract, initially for a period of one year, extendable thereafter, on the basis of performance and approval by SHA.

10. REFERENCE: MC-SHA

11. 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

12. 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 April 15, 2021