Kanda kumwanya uhisemo urebe amakuru yawo yose
Are you ready to embark on a transformational journey? We are seeking a dynamic and forward-thinking leader to join us as the Medical Advisor. If you thrive in dynamic environments and are committed to innovation and transformation, this is the opportunity for you!
The Rwanda Social Security Board aspires to transform towards a modern, high performing institution that is committed to delivering strategic corporate performance initiatives that ensure long-term sustainability.
This role offers a unique opportunity to drive improvement in access to high quality and cost-effective medical services to members of RSSB’ managed medical insurances, while insuring their long-term viability.
This role will require you to analyze medical services utilization in relation to existing policies, protocols and treatment guidelines and explore the latest evidence to provide valuable insights and comprehensive strategies that ensure quality health services to the growth and financial stability of Rwanda’s medical insurance schemes.
If you have a strategic mindset, the ability to navigate complex organizational environments and have what it takes to work in a fast-paced environment, then we are looking for you.
Reporting directly to the Health of Medical Advisor Services, the Medical Advisor will be responsible for providing advice in relation to facilitating access to quality and cost-effective medical services to RSSB members and providing recommendations for policy and guidelines changes in that regards. The Medical adviser will also be responsible for direct engagement with medical services providers and delivering quality service to customers through timely response to requests for pre-authorizations of medical services; and managing claims related to medical benefits.
About RSSB
The Rwanda Social Security Board (RSSB) has the mandate to manage and promote social security in Rwanda. RSSB’s vision is to provide a comprehensive social security system that caters to the diverse social security needs of the population, RSSB plays an important role in realising Vision 2050 and the National Strategy for Transformation (NST1). RSSB manages six social security schemes, namely: Pension, Occupational Hazards, Medical scheme, CBHI, Maternity Leave Benefits and EjoHeza (Long-term Term Saving Scheme).
As a leading player in the financial sector, RSSB serves as the largest institutional investor in Rwanda. With assets under management amounting to 1.9 trillion Rwf, which is equivalent to 17% of the country’s GDP, RSSB invests in key sectors of the economy and plays a crucial role in the functioning and growth of the financial sector. With approximately 12 million members, encompassing 90% of Rwanda’s population, RSSB is at the forefront of securing the health and financial well-being of Rwandans.
To achieve its important mandate, RSSB is embarking on a transformative journey, aiming to become a modern, data-driven, and high-performing institution. As part of this ambitious initiative, we are seeking highly motivated individuals who are results-oriented and uphold the highest standards of professionalism and integrity. By joining RSSB, you will have the opportunity to actively contribute to the advancement of social security and overall transformation of Rwanda.
If you are passionate about making a meaningful impact, ready to embrace innovation and change, and eager to work in a dynamic and collaborative environment, then RSSB is the place for you.
Key duties and responsibilities
- Ensure timely response to requests for pre-authorizations of medical services;
- Provide quality service to customers in managing claims related to medical benefits (in accordance with standards set);
- Collaborate with the Ministry of Health and other Stakeholders and active participation in technical working with matters pertaining to the medical benefits (Tariff of medical acts, medicines, consumables, etc. Nomenclature of medical acts & procedures, Standard treatments protocol);
- Contribute to the development/updating of health benefits packages based on information from medical advisory services;
- Analyze reports from medical advisory services and make recommendations with regards to maintaining the list of services from the list for pre-approval;
- Participate in tariff negotiation with medical services partners and in development of list of reimbursed drugs;
- Support the medical benefits teams during reconciliation with medical partners and during counter-verification of medical benefits invoices as well as medical audits;
- Review the clinical guidelines, standard treatment guidelines, and protocols, identify loopholes that open to abuse of medical services and liaise with the professional societies and Ministry of health to make necessary adjustments;
- Promote efficiency in health service utilisation by monitoring compliance to referral system, preference to primary health care services, and selecting most competitive providers of services and products during the approval process;
- Select requests for the attention of the medical committee and participate to the medical committee meetings;
- Support forecast the risk and liability for future benefits payments through analysis of claim data, mortality, accident, sickness, disability, health services utilization…etc;
- Investigate Non-compliance, malpractices and fraudulent practices with RSSB Partners and make recommendations;
- Educate patients about their diagnosis and treatment options, and answering questions about their condition, counseling patients on matters such as lifestyle changes that can help manage chronic conditions or illnesses;
- Ensure aggressive cost containment through tight adjudication, correct evaluation of medical appropriateness and successful negotiation;
- Case management of complex high value cases, by visiting to hospitalized members with long-term or complex treatment and discuss with treating Doctors on efficient management plan;
- Participate in the department’s performance improvement initiatives through periodical strategic and business plans and reports as well as promotion of innovations within the department;
- Perform any other duties as may be assigned from time to time
Key qualifications and experience
The successful candidate must have at least:
- Bachelor’s Degree in Medicine, Public health, Epidemiology, with at least 5 years’ experience, 3 of which in clinical practice
- Master of medicine (MMed) or master’s in public health, Health Economics, Epidemiology or a relevant field will be an advantage
Key competencies
Technical competencies:
- The role holder must have clinical skills.
- The incumbent must have sound understanding in data analysis and interpretation.
- The role holder must have sound understanding of Cost benefits analysis.
- The incumbent must have sound understanding in health sector policies and regulations,
- The role holder must have sound understanding in health insurance policies and procedures
Behavioral competencies:
- Must demonstrate impeccable customer service focus, strategic thinking, and strong ethical background with an ability to resist and zero tolerance for corrupt, political and other undesirable influences;
- Must be able to establish and maintain constructive and effective relationships with key stakeholders and staff alike;
- Must be open to change and adapt established methods for new uses within the institution;
Additional Information:
The position is based in Kigali, Rwanda and applicants must be willing to relocate outside their countries of domicile.
RSSB reserves the right to appoint or to issue an employment contract to the successful candidate.
Interested candidates are advised to visit the RSSB website for a more detailed job description for the role, and submit your application online by 11 January 2024.
In addition, please attach a curriculum vitae that contains details of your qualifications, experience and positions held relevant to this role. Include your day and evening telephone numbers, email address, names and address of three professional referees. Also, attach copies of your academic and professional qualifications.
Any form of canvassing will lead to automatic disqualification.
Only short-listed applicants will be contacted.
Shortlisted candidates will be required to submit a valid Criminal Clearance Certificate.
RSSB is an Equal Opportunity Employer
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