Qualifications, Skills and Experience Required:

• Fifteen 15 years of cumulative service period of relevant work experience, with at least three 3 years at Assistant Director level or comparable.
• Bachelor’s Degree in Medicine, Nursing, Clinical Medicine, Medicine and Surgery, Statistics, Mathematics, Health Financing, Health Economics, Pharmacy, Actuarial Sciences, Dentistry, Commerce, Accounting, Business Administration, Finance or Economics, Business, Social Science, or equivalent from a recognized institution.
• Master’s Degree in Medicine, Nursing, Medicine and Surgery, Business Administration, Public Health, Health System Management, Health Economics, Health Financing, Statistics, Mathematics, Strategic Management, Finance, Business Administration, or equivalent from a recognized institution.
• Membership of a recognized professional body/Institute in good standing.
• Certificate in Leadership courses lasting at least four 4 weeks from a recognized institution.
• A valid practicing license where applicable from a recognized institution.
• Demonstrated managerial, administrative, and professional competence in work performance and results.

Responsibilities:

Job Purpose: 

This cadre is responsible for implementing the SHI Act in respective areas of jurisdiction and ensuring efficient and effective service delivery through Branch Offices, Huduma, and Primary Care Network PCN Centres. Deputy Directors from Registration and Compliance, Claims Management, and Benefits Management may be deployed to this office.

Job Description: 

• Overseeing implementation of the SHA Act, legislations, policies, strategies, standards, and guidelines.
• Monitoring, analyzing, and reporting on the performance of Branches as a strategic business unit.
• Driving member registration, revenue collection, and claims processing in the Branch.
• Identifying new business opportunities within the Region of jurisdiction through analysis of needs and trends, and providing documented recommendations.
• Initiating and recommending the establishment and relocation of branches within the region.
• Implementing strategies to eliminate fraud, wastage, and abuse at branch level.
• Supporting engagement of communities within the Region to build the credibility and reputation of SHA and the social insurance sector.
• Enhancing communication between Branches in the Region, Headquarters, and other business functions like Huduma Centers.
• Ensuring prudent management of Cost Centers.
• Liaising with branch heads to prepare work plans and budgets.
• Following up medical cases to identify and manage high-risk cost cases.
• Preparing and submitting periodic reports on branch performance.
• Convening periodical stakeholder engagements.
• Ensuring audit functions are conducted at the region and branch offices.
• Preparing regular financial and operations reports for the Region.
• Monitoring benefit administration and utilization in Branches.
• Arbitrating between Branches regarding areas of jurisdictions.
• Providing assurance that appropriate institutional policies and procedures are followed.
• Evaluating the adequacy and reliability of information available to branch management for decision-making.