Programs Officer, NHIA/Public Sector Operations

Job Objective

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 clinical expertise to programme evaluation and outcome measurement

People & Team Management

• Own programme reporting templates, stakeholder communications, and documentation for the McKinsey partnership workstream
• Coordinate data submissions and milestone tracking for the programme

Education/ Professional  Qualification

Bachelor’s degree in Health Sciences, Public Health, Business Administration, or related field

Experience

• Experience in public health programme management
• Experience in health insurance operations, HMO administration is an advantage