Programs Officer, NHIA/Public Sector Operations

Programs Officer, NHIA/Public Sector Operations

To manage the administrative, operational, and programme delivery functions of the NHIA/Public Sector Operations Unit, ensuring all payment processes, provider management activities, regulatory submissions, and programme reporting are executed accurately and on time.

Responsibilities

• Payment & Claims Administration

• Coordinate monthly NHIA capitation payments for FSSHIP to over 1,300 healthcare facilities

• Coordinate monthly NHIA FFS (Fee for Service) payments to healthcare facilities

• Manage end-to-end CEMONC claims processing, portal uploads, payment evidence documentation, and reimbursement letters to the Director General, NHIA

• Oversee claims reconciliation exercises for CEMONC and FSSHIP programmes

• Provider Management

• Manage the onboarding and training of new NHIA FSSHIP facilities in coordination with the Provider Liaison Officer

• Oversee adoption, execution, and retrieval of contracts with partner healthcare providers

• Supervise the Provider Liaison Officer and CEMONC Claims Verifiers on day-to-day operations

• Monitor facility performance and escalate issues to the Clinical Officer as required

• Reporting & Regulatory Submissions

• Prepare and submit weekly CEMONC programme reports to NHIA and all relevant stakeholders

• Ensure FSSHIP and CEMONC records and data meet NHIA regulatory accuracy standards

• Coordinate the organisation’s representation at NHIA and stakeholder events, logistics and documentation

• Maintain a regulatory submissions calendar and ensure all deadlines are met

• Contract Staff Coordination

• Coordinate and supervise all contract staff within the unit, task allocation, quality review, and performance monitoring

• Manage the scheduling, training, and retraining of CEMONC claims verifiers and FSSHIP claims officers

• Escalate capacity issues and recommend contract staff adjustments to the Group Head

• Other Public Sector Programs

• Serve as clinical lead on public health programme design, quality metrics, and clinical governance frameworks within the McKinsey partnership workstream

• Contribute to the design and execution of clinical governance and performance metrics for NHIA/public sector engagements

• Collaborate with cross-functional teams to ensure alignment with strategic objectives and regulatory requirements

Qualifications

• BA/BSc/HND
• Job Type: Full Time
• Location: Lagos
• Job Field: Project and Program Management
• Experience: Not specified
• Industry: Insurance
• Education: BA/BSc/HND
• Additional details: The posting includes sections for responsibilities, requirements, and qualifications, outlining extensive operational, regulatory, and contract management duties within NHIA/public sector operations.