Technical Expert Health Finance: National Health Insurance Specialist

4 weeks ago

Pretoria, Gauteng, South Africa Panagora Group Full time

Background to TSS

The Technical Support Services (TSS) Activity helps USAID/Southern Africa address technical priorities and develop creative, innovative solutions to strategically allocate resources, strengthen connections with partners, and replicate best practices and effective program models. Through the TSS contract, Panagora Group augments capacity by providing technical, operational, and administrative support to USAID/Southern Africa's portfolio. TSS deploys advisors in response to USAID requests for priority work with government stakeholders, implementing partners, and/or other entities. TSS supports USAID staff and teams to integrate creative solutions into routine work. TSS also provides international and local expertise for surge support, as needed, for USAID Program Cycle requirements, planning, development, outreach, communications, and Health Office human resource functions.

Background to this SOW

The National Department of Health is seeking a Technical Expert Health Finance (NHI) to support the Deputy Director General within the National Health Insurance Directorate. The technical expert will focus on designing and implementing a capitated payment mechanism for primary healthcare providers in selected proof-of-concept Contracting Units for Primary Health Care (CUP) sites.

Implementing Contracting Units for Primary Health Care (I-CUPs) Programme

Launched in August 2022, the CUPs program aims to implement the CUP model in designated sub-districts across all nine provinces, each selected as a proof-of-concept area. This initiative involves testing key components of the NHI framework, including digital user registration, provider accreditation, and reimbursement, with the intent of transitioning to a capitation payment model.

Capitation Models

Capitation models involve payments made on a per-person basis, serving as both a funding formula for CUPs and a reimbursement mechanism for healthcare providers. During the proof-of-concept phase, most services will be delivered by Provincial Departments of Health and funded through Provincial Equitable Shares, while the NHI Indirect Grant will support additional services, particularly from private providers.

Capitation Payment Mechanisms

Under a capitation model, providers receive a fixed payment for each registered user over a specified period, regardless of whether care is provided. Payments are based on the average healthcare needs of users and can include risk adjustment for populations needing more care. While capitation models enhance provider autonomy and efficiency and mitigate financial risk, they also carry the risk of cost-cutting that may compromise care quality. Therefore, it is essential to combine capitation with performance-based payment components to ensure quality care and patient outcomes.

Position Responsibilities

The I-CUPs program provides a unique opportunity to apply existing international and local research on capitation design, including insights from the 2018 GTAC capitation project, to develop a tailored approach for South Africa. The framework for designing an outcomes-based capitation model for primary care reimbursement in proof-of-concept CUP areas is outlined below.

Key Tasks and Deliverables:

  • Literature Review: Examine existing research on capitation and risk adjustment.
  • Progress Report: Provide oversight, guidance, and support for the I-CUPs program.
  • Internal Consultation Report: Assist the Deputy Director General (DDG) in consultations regarding the primary care capitation contract.
  • External Stakeholder Presentation: Support the NDOH team in consultations with external stakeholders on the primary care capitation contract.
  • Methodology Development: Create a detailed methodology for calculating the risk-adjusted capitated fee and facilitate decision-making processes.
  • Scenario Planning Document: Aid in discussions with providers and stakeholders regarding the proposed risk-adjusted capitated fee.
  • Facilitation of Consultations: Lead discussions on outcomes-based payment design, including HIV/TB-related outcome measures.
  • Data Collection Specifications: Develop detailed requirements for data collection and reporting.
  • Capitation Manual Refinement: Update and refine the capitation manual.
  • Pilot Report: Prepare a report on the NHI and CUPs pilot.

  • National Migration Health Specialist

    2 weeks ago

    Pretoria, Gauteng, South Africa IOM Full time

    Job Title: National Migration Health SpecialistThe International Organization for Migration (IOM) is seeking a qualified National Migration Health Specialist to join its team. This position will be based in Pretoria, South Africa.Core Functions and Responsibilities:Ensure efficient daily operations of the Migration Health Assessment Centre (MHAC) in close...

  • Programme Manager

    4 weeks ago

    Pretoria, Gauteng, South Africa Health Systems Trust Full time

    Job Title: Programme Manager - Health Systems StrengtheningWe are seeking a highly skilled Programme Manager to join our team at the Health Systems Trust (HST). The successful candidate will be responsible for leading the implementation of our health systems strengthening programme, working closely with our team to develop and implement strategies to improve...

  • Occupational Health Specialist

    3 weeks ago

    Pretoria, Gauteng, South Africa Thusa Batho Labour Solutions Full time

    Job SummaryThusa Batho Labour Solutions is seeking a highly skilled Occupational Medical Practitioner to join our team. The successful candidate will be responsible for managing the Occupational Health Centre and ensuring compliance with relevant legislation.Key ResponsibilitiesConduct health risk assessments and diagnose work-related ill health...

  • Senior Health Systems Development Manager

    1 day ago

    Pretoria, Gauteng, South Africa Health Systems Trust Full time

    We are seeking a Senior Health Systems Development Manager to join our team at the Health Systems Trust.Job SummaryThe successful candidate will be responsible for leading healthcare projects and managing teams to improve primary health care in South Africa.About the RoleAlign all activities for the SyNCH web-based system, including transition to the...

  • National Migration Health Physician

    4 weeks ago

    Pretoria, Gauteng, South Africa IOM Full time

    Job Title: National Migration Health PhysicianAt IOM, we are seeking a highly skilled and experienced National Migration Health Physician to join our team in Pretoria, South Africa.Job Summary:The National Migration Health Physician will be responsible for ensuring the efficient daily operations of the Migration Health Assessment Centre (MHAC) in Pretoria,...

  • Occupational Health Specialist

    3 weeks ago

    Pretoria, Gauteng, South Africa Thusa Batho Labour Solutions Full time

    Job Title: Occupational Medical PractitionerJob Summary:Thusa Batho Labour Solutions is seeking an experienced Occupational Medical Practitioner to join our team. The successful candidate will be responsible for managing the Occupational Health Centre and ensuring compliance with OHS Act and Health Act regulations.Key Responsibilities:• Conduct health risk...

  • National Migration Health Physician

    4 weeks ago

    Pretoria, Gauteng, South Africa IOM Full time

    Job Title: National Migration Health Physician - Medical OfficerAt IOM, we are seeking a highly skilled and experienced National Migration Health Physician - Medical Officer to join our team in Pretoria, South Africa.The successful candidate will be responsible for ensuring the efficient daily operations of the Migration Health Assessment Center (MHAC) and...

  • Global Migration Health Expert

    2 weeks ago

    Pretoria, Gauteng, South Africa IOM Full time

    Job Title: Global Migration Health ExpertJob Summary: The successful candidate will be responsible for ensuring the efficient daily operations of the Migration Health Assessment Center (MHAC) in Pretoria, South Africa. The candidate will also conduct migration health assessments to fulfill the technical requirements of resettlement countries.Key...

  • Senior Health Systems Advisor

    2 weeks ago

    Pretoria, Gauteng, South Africa Panagora Group Full time

    About the RolePanagora Group is a social enterprise dedicated to providing high-quality, high-impact international health, development, and learning consulting. We are a dynamic woman- and employee-owned small business partner focused on market-based and integrated local solutions that strengthen country capacity and independence; and on learning,...

  • Medical Health Specialist

    7 days ago

    Pretoria, Gauteng, South Africa Thusa Batho Labour Solutions Full time

    Occupational Medical Practitioner/Doctor Job OpportunityWe are seeking an experienced Occupational Medical Practitioner/Doctor to join our team at Thusa Batho Labour Solutions in Pretoria. The successful candidate will be responsible for providing comprehensive occupational health services to our clients.About the Role:This is a unique opportunity for a...

  • National Migration Health Physician

    2 weeks ago

    Pretoria, Gauteng, South Africa IOM Full time

    Job SummaryWe are seeking highly skilled and experienced professionals to fill the position of National Migration Health Physician – Medical Officer. This role will be based in Pretoria, South Africa, and will involve working with the Migration Health Assessment Center (MHAC) team.Key ResponsibilitiesEnsure the efficient daily operations of the Migration...

  • Senior Policy and Health Systems Advisor

    4 weeks ago

    Pretoria, Gauteng, South Africa Panagora Group Full time

    Job Summary Panagora Group is a social enterprise dedicated to providing high-quality, high-impact international health, development, and learning consulting. We are a dynamic woman- and employee-owned small business partner focused on market-based and integrated local solutions that strengthen country capacity and independence; and on learning,...

  • Finance Professional

    1 week ago

    Pretoria, Gauteng, South Africa Rakkgalakane Full time

    Job OverviewWe are seeking a skilled Finance Professional to join our team at Rakkgalakane. As an Accounts Payable Expert, you will play a crucial role in ensuring the smooth operation of our financial processes.Key ResponsibilitiesYour primary responsibilities will include:Managing accounts payable, ensuring timely payments and maintaining accurate...

  • Senior Construction Health and Safety Specialist

    6 days ago

    Pretoria, Gauteng, South Africa BCB Solutions Ltd Full time

    About the RoleBCB Solutions Ltd is seeking a highly skilled Senior Construction Health and Safety Specialist to join our team. This role will play a critical part in ensuring that all sites operated by the company adhere to the highest standards of health and safety.Job Description:Health and Safety Management Systems: Develop, implement, and maintain robust...

  • Global Health Specialist

    1 day ago

    Pretoria, Gauteng, South Africa mothers2mothers (m2m) Full time

    Company Overviewmothers2mothers (m2m) is a pioneering African Primary Health Care organisation that harnesses the power of women living with HIV as community health workers across multiple African nations. By employing local women as community health advocates, we deliver a model that prioritises healthcare for families who need it most, by women who...

  • Occupational Therapist

    2 weeks ago

    Pretoria, Gauteng, South Africa Nurture Health Full time

    About the Role:We are seeking a skilled Occupational Therapist to join our team at Nurture Vereeniging in Gauteng. The ideal candidate will have a BSc in Occupational Therapy and be registered with HPCSA as an independent practitioner.Key Responsibilities:Deliver high-quality occupational therapy services to patients in a rehabilitation...

  • **Procurement Specialist for Youth Health Programme Materials**

    2 weeks ago

    Pretoria, Gauteng, South Africa DG Murray Trust Full time

    Project OverviewThe DG Murray Trust is seeking a Procurement Specialist to manage the procurement of printed materials for the Youth Health Programme.The programme aims to support the South African vaccination campaign by providing printed materials for delivery to four provinces throughout the country.The procurement will be conducted by means of the single...

  • Health and Safety Specialist

    4 weeks ago

    Pretoria, Gauteng, South Africa NALEDI YA KANANA PROJECTS PTY LTD Full time

    Job Title: Health and Safety OfficerNALEDI YA KANANA PROJECTS PTY LTD is seeking a skilled Health and Safety Officer to join our team.Key Responsibilities:Prove safety management, advice, monitoring, and reporting in the workplace.Develop and implement health and safety policies and procedures.Monitor and control safety and compliance in the organization,...

  • iOS Developer

    2 weeks ago

    Pretoria, Gauteng, South Africa CodeConnect Staffing (Pty) Ltd Full time

    Job DetailsWe are actively seeking an experienced iOS Developer to join our dynamic team at CodeConnect Staffing (Pty) Ltd. As a key member of our development team, you will be responsible for designing, developing, and maintaining iOS platforms, primarily focusing on health solutions.Key Responsibilities:Develop and maintain iOS applications, ensuring...

  • Technical Lead for NHI Framework Development

    2 weeks ago

    Pretoria, Gauteng, South Africa Panagora Group Full time

    About the ProjectThe National Health Insurance (NHI) framework in South Africa aims to achieve universal health coverage and improve access to quality healthcare services. As part of this initiative, Panagora Group is seeking a Technical Lead for NHI Framework Development to support the National Department of Health (NDOH) in designing and implementing a...