Vacancy Announcement: Senior Claims Management Officer (96 Positions)
The Authority invites applications for the position of Senior Claims Management Officer, a key role in strengthening efficiency, accountability, and transparency in health claims management. This is one of the largest recruitment exercises in recent years, offering 96 permanent and pensionable positions across the country. It presents an excellent opportunity for experienced professionals to build stable careers while contributing directly to the improvement of healthcare financing and service delivery.
Position Details
- Job Title: Senior Claims Management Officer
- Reference Number: SHA/185/2025
- Term: Permanent and Pensionable
- Number of Positions: 96
- Job Level: SHA 6
- Deadline: October 3, 2025, at 5:00 p.m.
Minimum Qualifications
- Bachelor’s degree from a recognized institution
- Valid practicing license (where applicable)
- Membership in a relevant professional body, in good standing
- Proficiency in computer applications
Experience Requirements
Promotional – Claims Management (Medical Review)
- At least three (3) years’ experience at the level of Claims Management Officer I or in a comparable role
- Bachelor’s degree in Medicine and Surgery
- Valid practicing license and professional membership
- Proven merit and ability in performance and results
Promotional – Claims Management
- At least six (6) years’ cumulative service, including three (3) at the level of Claims Management Officer I or equivalent
- Bachelor’s degree in Medicine, Nursing, Clinical Medicine, or Medicine and Surgery
- Membership in a recognized professional body in good standing
- Strong computer skills and proven track record in performance
Key Responsibilities
Successful candidates will be deployed in one of three functional areas:
- Claims Management (Medical Review) – Reviewing and validating medical claims, appraising claims against benefit packages, processing pre-authorizations, operationalizing e-claims systems, and sensitizing claimants on fraud prevention.
- Claims Management – Processing claims, implementing pre-authorization processes, conducting surveillance to detect irregularities, preparing quarterly reports, and enforcing compliance with contractual obligations.
- County Coordination (Quality Assurance and Surveillance) – Overseeing branch-level compliance, conducting quality assurance, enforcing contractual agreements with providers, maintaining records of empaneled facilities, detecting fraud, and strengthening benefit utilization monitoring.
Why This Role Matters
Senior Claims Management Officers are central to ensuring fair, efficient, and transparent handling of claims. By validating claims, preventing fraud, and streamlining reimbursement processes, they:
- Safeguard the integrity of healthcare financing
- Ensure timely access to healthcare services for beneficiaries
- Support healthcare providers through accurate reimbursements
- Protect public funds by reducing fraudulent claims
- Build public confidence in the health system
Career Growth and Benefits
- Permanent and pensionable terms for long-term stability
- Clear opportunities for professional advancement
- Diverse assignments at both national and county levels
- Direct contribution to building a transparent and accountable health system
Application Procedure
All applications must be submitted online through the Authority’s careers portal by October 3, 2025, at 5:00 p.m. Late applications will not be considered.
Qualified candidates who are passionate about accountability and efficiency in healthcare claims management are encouraged to apply.
No comments:
Post a Comment