REF: NHIF/DIA/007/22
Functionally reporting to the Board of Management and administratively to the Chief Executive Officer, the successful candidate will develop and provide strategic internal control policies and systems in the Fund.
JOB PROFILE

Develop internal audit strategies, policies, systems and procedures;
Coordinate programmed and ad hoc audits of operations and activities of the... Fund to monitor and evaluate use of the resources;
Coordinate any required forensic audit.
Develop and execute a risk-based Internal Audit Plan
Assess the operational effectiveness of the design and functioning of controls and processes
Advise the Fund on best practice regarding the internal controls, systems and governance processes;
Formulate actionable and value-added recommendations and monitor progress of implementation of action plans;
Design, develop and update internal audit work plans, audit programmes and audit manual.
Ascertain the reliability of management data developed within the Fund;
Facilitate the periodic review of internal control systems to ensure their adequacy to prevent errors and irregularities;
Evaluate measures put in place by management to ensure that the Fund’s assets are accounted for and safeguarded from losses of all kind;
Monitor and appraise performance of Internal Audit staff in line with quality standards and work processes to ensure the achievement of the departmental objectives and recommend operating improvements;
Review the risk management process and its implementation across NHIF to embed a proactive approach in identification of risks.
Monitor implementation of all policies and procedures to ensure that all decisions made adhere to regulations and set standards;
Liaise and work closely with law enforcement agencies mandated to conduct investigations into incidents of fraud and other irregularities

Key Competencies

Ability to promote the value of internal audit among key employees within the organization
Independent- minded, highly inquisitive individual of high integrity.
Highly analytical and a critical thinker
Strong Communication skills, both oral, report writing and presentation skills
Strong interpersonal skills
General IT knowledge
Keeping abreast with regulatory changes and industry standards.

Person Specifications
For appointment to this grade, an officer must have:-

At least fifteen (15) years’ work experience five (5) of which should be in Senior management;
Have a Bachelors Degree in any of the following disciplines: Accounting, Finance or Business Administration (Finance and Accounting option) or a relevant field from a recognized university;
Have a Masters degree in any of the following disciplines: Business Administration (Accounting/Finance Option) or a relevant field from a recognized institution;
Have passed Certified Public Accountant of Kenya (K) or its equivalent qualification;
Be a registered member of ICPAK in good standing and OR CFE (Certified Fraud Examiner) OR Be a Member of the IIA/ISACA in good standing;
Leadership and Management course lasting not less than four (4) weeks from a recognized institution;
Be proficient in computer application skills;
Have demonstrated professional competence and ability as reflected in work performance and results;
Fulfilled the requirements of Chapter six of the Constitution. more

REF: NHIF/DICT/006/22
Reporting to the Chief Executive Officer, the successful candidate will provide strategic corporate Information and Communication Technology services including selection, acquisition, development and installation of all ICT systems, applications and infrastructure
JOB PROFILE
Leadership and Advisory

Lead, direct and oversee ICT function and ensure continuous operation... and cost-efficiency of the ERP information systems, data analytics systems, networks, database and data security systems.
Develop and implement NHIF’s ICT strategy in consultation with the Board, Chief Executive Officer and other directorates;
Lead the development and implementation of the Information Systems & Security and Infrastructure and Services departments’ strategic and operational plans and performance measurement that promotes accountability and success;
Lead and promote a strong internal ICT customer service culture, ensuring a service delivery approach that is responsive to the operational and strategic needs of the NHIF;
Oversee the development, implementation, coordination and the preparation of strategic procurement plans and tender specifications for purchasing capital equipment, goods and services as provided in the annual budget of the Directorate of ICT. Infrastructure Design and Support
Supervise the management of planning, development, deployment, operations and maintenance of IT based information systems in NHIF, including the branches;
Supervise the management of secure NHIF ICT enterprise infrastructure and services;
Guide and coordinate all ICT projects related to selection, acquisition, development and installation of major information systems for NHIF while managing all ICT vendor relationships; development and implementation of  systems for data analytics, data quality assurance and accountability for data management and use;
Policy Development and Implementation and Innovation
Oversee development and implementation of ICT policies;
Develop, manage and monitor the ICT budgets and policy guidelines
Seek for innovative, integrated, reliable and sustainable technology services.
promote a culture of continuous improvement and business excellence, recognizing achievement and innovation;

Stakeholder Engagement

Coordinate the development and implementation of systems for data analytics, data quality assurance and accountability for data management and use;
Implement and educate on cost effective, best practice and sustainable ICT capability for internal and external stakeholders including Scheme members and healthcare providers;
Oversee coordination of ICT needs with other NHIF directorates, branch offices and external institutions to support planning and development of information systems;
Build a sustainable positive working environment within the Directorate for ICT

Key competencies

Critical Thinking and Problem Solving.
Strong Communication and interpersonal skills.
Ability to collaborate and make individual contributions on an unprecedented scale.
Ability to adapt to rapid changes without losing focus on the strategic goal.
Ability to establish and lead a team to achieve a common goal.
Strong work and professional ethic and integrity.
Manage strong relationships with both internal and external customers

Person Specifications
For appointment to this grade an officer must have at least:

At least fifteen (15) years’ work experience five (5) of which should be in Senior management;
Master’s Degree in any of the following disciplines: -Information Technology, Computer Science, Business IT, Software Engineering, ICT Project Management, Computer Engineering, Data protection & Security or any other relevant and equivalent qualification from a recognized Institution;
Bachelor’s Degree in any of the following: Information Technology, Computer Science, Business IT, Software Engineering, ICT Project Management, Computer Engineering or their equivalent from a recognized Institution;
At least any one (1) certifications in either IT management or Information Security or Professional certifications such as CISM, CEH, CompTIA Security+, CISSP, GSEC CompTIA Project+, CAPM, CGEIT, CSM, CISSP, COBIT, CCNP, CDCP, CCNA Cloud, CCNA Industrial/IoT, CCNA, MCSE, MCSA, MCSD, N+, A+ OCA, CISSP, Linux+, Network+, Microsoft Certified IT Professional (MCITP) or their equivalent;
Be a member of a relevant ICT professional body;
Leadership and Management Course lasting not less than four (4) weeks from a recognized institution;
Fulfilled the requirements of Chapter Six of the Constitution;
Demonstrated merit and ability as reflected in work performance and results more

REF: NHIF/CSLS/005/23
Reporting functionally to the Board of Management and administratively to the Chief Executive Officer, the successful candidate will head the legal department and is responsible for the legal affairs of the entire corporation including provision of legal counsel to the board of directors, chief executive officer and other senior management. The candidate must possess strong... initiative, excellent management and leadership skills and strong business acumen.
JOB PROFILE

Provide guidance on the proper application and interpretation of laws and regulations and ensure adequacy of controls to mitigate legal and other risks that may arise.
Establish and maintain effective legal processes, systems and standardized documentation.
Lead the provision of legal advice to the Board, management and staff, proffering solutions to legal problems, constraints, risks, options, consequences and approaches;
Ensure compliance with laws, rules and regulations by the Board and Management;
Vet and draft legal documents including contracts and leases;
Liaise with other government agencies and on legal matters affecting National Health Insurance Fund;
Render professional legal advice for any legal action to be initiated and/ or defending the interests of National Health Insurance Fund;
Monitor legal developments and trends in policies, bills, and serve as source of legal information.
Review and provide of feedback on legal aspects of all Committees of the Board
Ensure the Board and Management’s compliance with regulatory requirements.
Preparing legal opinions, advisories and briefs on litigation matters where necessary.
Organize and establish day-to-day management of legal staff.
Provide performance guidance and coaching of the legal staff.
Prepare and timely circulate Board minutes and Committee papers.

Key competencies

Ability to communicate and function in a change-oriented setting with good knowledge of Public Sector management.
Ability to interact with senior officials of other state agencies, corporate and government and to present legal advice on various management issues.
Excellent verbal and written communication skills in English.
Strong skills in drafting a variety of legal documents and communicating complex issues clearly and concisely.
Ability to review under strict deadlines long and complex transactions.
Negotiating skills and capacity to work with other non-legal professionals to develop innovative solutions to conflicting interests and positions;
Demonstrated leadership capabilities, including ability to organize and manage human resources to attain goals.

Person Specifications
For appointment to this grade, an officer must have:-

Must be been an advocate with at least fifteen (15) years’ work experience five (5) of which should be in Senior management.
Bachelors degree in law from a recognized institution;
Masters Degree in Law or equivalent Degree from any other relevant field;
Membership to ICPSK in good standing;
Certified Public Secretary (CPSK) or its equivalent qualification from a recognized Institution;
Postgraduate Diploma in Law from the Kenya School of Law;
Admitted as an Advocate of the High Court of Kenya;
Holds a valid practicing certificate.
Member of the Law Society of Kenya;
Leadership and Management course lasting not less than Four (4) weeks from arecognized institution;
Fulfilled the requirements of Chapter Six of the constitution;
Demonstrated competence in work performance more

REF: NHIF/DCS/004/23
Reporting to the CHIEF EXECUTIVE OFFICER, the successful candidate is responsible for the direction and management of Corporate Services of NHIF and for ensuring the provision of high-level systems and services for all administrative functions including human resources, building facilities, corporate communication and Branding and related support activities.
JOB... PROFILE
Leadership and General Management

Provide positive and professional leadership to staff ensuring that the directorate delivers effective support to the activities of National Health Insurance Fund;
Contribute to the management of NHIF, as a member of the Senior Management team, by participating in the generation of new ideas and fresh approaches to how NHIF manages its business;
Delegate appropriate responsibility for the provision of corporate services while retaining overall accountability for the delivery of those services;
Provide advice and support to all directorates and departments within the remit of Corporate Services;

Human Capital Development and Management

Oversee the human resource’s function, ensuring the provision of advice on HR matters to the Chief Executive Officer and Senior Management team, including the development and review of relevant HR strategies, policies and procedures;
Provide overall leadership in organizational development, talent sourcing and staffing, employment law, performance management, employee relations, and compensation and benefits.
Provide leadership and direction to the HR staff fulfilling the role of senior level advisor to Management executives and employees on human resources trends.
Develop and implement a NHIF human resources business plan, establishing accountability, identifying solutions to resolve problems and fostering a diverse workplace.
Establish short- and long-term goals, budgeting for HR expenses, and networking with outside peers and organizations when needed to achieve goals.
Lead the development of an occupational health and safety (OHS) system that is consistent with local and international standards; Administration, Property and Security Management
Manage the premises, facilities used by National Health Insurance Fund including the relationships with landlords, managing agents and other tenants where appropriate.
Procure and manage a range of facilities management services including catering, cleaning, security, and fire protection.
Develop, maintain and oversee property management, acquisition, disposal and rationalization strategy;
Oversee the provision of administrative and logistical support services.
Direct maintenance and security of the National Health Insurance Fund’s infrastructural equipment, machinery and facilities.

Policy Formulation and Implementation

Constantly review the corporate services’ policies and procedures and oversee the enforcement of statutory regulations.
Oversee the integration of corporate plans and programs in accordance with Government guidelines, priorities and the National Health Insurance Fund’s mission;
Lead in the effective communication of corporate strategies, policies and procedures.
Lead the development and continuous revision of standard operating procedures (SOPs)

Communication, Marketing and Branding

Oversee development of a strategic Integrated Marketing and Communication plan.
Ensure the IMC plan reflects consistent messaging and supports the Fund’s business and communication goals.
Oversee development of stakeholder collaterals
Ensure executive management team is always appraised of communication issues.

Key competencies

Proven track record of meeting ethical and confidentiality guidelines.
Excellent organizational skills and efficiency.
Experience managing and communicating organizational change.
Relevant work experience developing effective programs to support the initiatives of a complex and large organization
Proven track record of achieving results with demonstrated success in developing policies, procedures and processes and building systems and tools to support a transformation
Experience in implementing significant change management processes;

Person Specifications
For appointment to this grade, an officer must have:-

At least fifteen (15) years’ work experience five (5) of which should be in Senior management;
Bachelor’s degree in a related field from a recognized University;
Master’s degree in a related field from a recognized University;
Professional qualification and membership to a professional body where applicable;
Leadership and Management course lasting not less than four (4) weeks from a recognized institution;
Fulfill the requirements of Chapter Six of the Constitution more

REF: NHIF/DBPM/002/23
Reporting to the Chief Executive Officer, the successful candidate will be responsible for overall leadership and oversight in the implementation of sustainable operational strategies related to member registration and retention, revenue collections, benefits management, case management, claims processing, quality assurance and policies for enhancing increased accessibility... and quality healthcare for NHIF members and declared dependents geared towards Universal Health Coverage (UHC).
JOB PROFILE
Leadership and Advisory

Lead the development, implementation, monitoring and review of sustainable operational strategies relating to member registration and retention, revenue collections, claims processing, case management and quality assurance;
Lead stakeholder engagement activities that will enhance the achievement set targets in member registration, revenue collection, case management and claims processing;
Oversee empanelment of health providers and ensure they are operating in line within the contracts and set industry and professional standards.
Lead strategic purchasing initiatives.
Lead a team of professionals within the directorate.

Stakeholder Engagement

Provide technical advice to the Chief Executive Officer and Board of Management on issues of compliance, member registration, claims administration, healthcare provider surveillance, beneficiary satisfaction, disease patterns and trends;
Engage with the stakeholders in the Public, Private and Sponsored Programs Sectors to identify and optimize on membership registration opportunities;
Engage county governments and other potential partners in ensuring that all respective county residents have insurance membership with NHIF;

Healthcare Services

Develop, enhance, and implement diagnosis, procedure, and other classifications;
Develop, pilot, and implement prospective provider payment mechanisms;
Define cost modelling methodology and required data sets and develop costing manual;
Determine the prices of health care services, drugs and consumables based on developed costing manual;
Prepare and educate the public on the prices of services, drugs and consumables included in the Health Care Benefits;
Determine the method of drugs prescribing and determine the way of issuing of drugs covered by NHIF.
Refine referral guidelines;
Propose functions and funding for specific health services to be added to the NHIF on an incremental basis;
Participate in the Health Needs Assessment for clinical interventions, pharmaceuticals and technologies with other responsible bodies;
Compile the annual plan of needs for procurement of the Health Care Benefits;
Participate in the Health technology assessment (HTA) for clinical interventions, pharmaceuticals and technologies with other responsible bodies;

Contracting and Empanelment

Develop and implement performance based contracting methodology, including performance indicators, quality indicators, contract monitoring and payment terms;
Administer contracts ensuring efficient process of preparing, signing, reviewing, adjustment and payment based on performance reports;
Define standard operating procedures for the implementation of performance-based contracting, including contract performance monitoring, performance verification, payments, sanctions, grievance redress and contract renewal and modification;
Train NHIF service providers’ staff in the procedure of contracting of service providers, monitoring contract performance, identifying challenges, performance-based payments, and costing.

Claims Management

Develop and implement policies and strategies for effective and efficient management of claims;
Ensure both employer and individual member accounts are managed properly;
Collect, analyze, monitor and control reports/invoices from contracted health facilities;

Customer Care, Case Management and Quality Assurance

Manage the process of receiving and processing complaints from Beneficiaries;
Oversee the operations of the call centre;
Perform preauthorization of benefits, concurrent review of patients undergoing treatment and post hospitalization reviews.
Perform Beneficiary’s satisfaction surveys and undertake other diagnostic studies;
Coordinate the production and dissemination of all monitoring and evaluation reports including statistical reports;
Facilitate and undertake investigations of Beneficiary fraud and corruption.
Facilitate investigations of Health Service Provider fraud and corruption. Policy Development
Develop and implement strategies that enhance membership registration, retention and revenue growth;
Develop and implement policies on regional and branch network expansion that will ensure NHIF services are accessible across the country;
Develop and implement policies and strategies for effective and efficient case management and clinical audits;
Develop and implement policies and strategies on business process re-engineering;
Develop and implement policies on minimum acceptable quality benefits by healthcare facilities;
Develop and implement strategies for enhancing increased accessibility to healthcare facilities by NHIF members and their declared dependants;

Information & Communication Technology

Support development of Prospective provider reimbursement mechanisms in the operating ICT systems;
Develop and implement medical procedure codes in the operating ICT systems;

Key competencies

A strategic thinker with problem-solving, analytical, innovative and creative skills
Proactive
Ability to develop networks, alliances and collaborate widely to build and maintain strategic relationships.
Strong acumen to effectively manage multiple stakeholders with diverse interests.
Demonstrable professional and personal integrity
Ability to persuade others, build consensus and gain cooperation.
Strong experience in managing and building staff capabilities.
Strong communication and interpersonal skills

Person Specifications
For appointment to this grade, an officer must have :-

At least fifteen (15) years’ work experience five (5) of which should be in Senior management;
Bachelor’s degree in economics, Business, Medicine, Social Science, Pharmacy, actuarial sciences or any other related field from a recognized Institution;
Master’s degree in economics, Business, Medicine, Social Science, Pharmacy, actuarial sciences or any other related field from a recognized Institution;
Professional qualification in actuarial science and membership will be an added advantage;
Leadership and Management course lasting not less four (4) weeks from a recognized Institution;
Proficiency in Computer Applications;
Fulfil the requirements of Chapter 6 of the Constitution more

REF: NHIF/DFS/003/23
Reporting to the Chief Executive Officer, the successful candidate will establish, maintain and provide leadership on sound financial management to include budget, investments and liabilities.
JOB PROFILE
Leadership And Advisory

Lead and develop a team of finance professionals within the finance directorate.
Lead in the development and management of the ERP finance and... accounting system
Oversight general program activities inventory management, staff advances, cash and bank management.
Provide technical advice to management and staff on financial compliance of statutory and legal requirements.
Oversee the interpretation and implementation of government policies in accordance with the
PFM Act.
Lead and coordinate tax returns to ensure compliances, information reporting and other statutory requirements and advise the Chief Executive Officer and the Board on effective strategies for minimizing tax liability;
Interpret financial reports, statements, accounting records and advice the CHIEF EXECUTIVE OFFICER on the significance of the same.
Oversee timely preparation of annual work plans and budget estimates.
Lead in presenting proposed budgets to the Board, Treasury Officials and Donor Agencies as appropriate.

Financial Policies and Systems

Develop and install effective financial management systems and procedures to improve financial reporting and accounting in collection of member contributions.
Establish stringent expenditure control ensuring that budgetary allocations are not exceeded without justifiable cause;
Develop and implement computerized financial information systems to include general ledger, job costing and fixed assets management register.

Financial Monitoring and Tracking

Prepare financial statements and other reports to summarize current and projected financial position including healthcare providers’ account reconciliations.
Monitor and track the utilization of capital and operational expenditure against approved plans.
Coordinate and monitor the NHIF’s investment of surplus funds and implement effective strategies for managing working capital and expenditure programs;
Manage the cash flow and funding for smooth operations.

Key competencies

Risk Management skills to understand the source of risk, evaluate and their mitigation.
Ability to assess and facilitate change.
Takes critical and methodical approach when problem solving
Leads others, manages resources and delegates effectively.
Methodical approach to problem-solving.
Business skills to understand business operations and ethical issues.
Strong interpersonal and communication
Stakeholder management.

Person Specifications
For appointment to this grade, an officer must have:-

At least fifteen (15) years’ work experience five (5) of which should be in Senior management;
Masters degree in Business Administration (MBA) or related field from a recognized Institution;
Bachelors degree from a recognized Institution;
Certified Public Accountant CPA (K) or ACCA (UK) or equivalent qualification;
Membership to ICPAK or relevant professional body;
Leadership and Management course lasting for not less than 4 weeks from a recognized Institution;
Fulfill of the requirement of chapter 6 of the constitution. more

REF: NHIF/DBPM/002/23
JOB PURPOSE/PROFILE
The Chief Executive Officer shall be responsible to the Board of Management for providing strategic leadership in operational, financial and management of the Fund through development and implementation of Strategic plan and effective management of resources to achieve overall mandate.
Job Summary

The chief executive officer shall, subject to the... directions of the Board, be responsible for the day-to-day management of the Fund.
Provide strategic leadership to the Fund to deliver on its mandate as per the NHIF Act;
Responsible for the execution and communication of the Board’s strategies, decisions, and policies;
Promotes the Funds corporate image and foster positive engagement with stakeholders;
Provide leadership in development and implementation of the Funds strategic plan and business plans.
Formulate, implement and review policies, strategies, guidelines, and standards of the Fund;
Oversees the operational and financial management of the Fund and reporting to the Board
Liaises with the Board in ensuring fulfillment of the Governance function.
Serve as the link between the Board and the Management.
Provide regular, thorough, and prompt communication to the Board on key technical, financial, and administrative matters.
Advise the Board on the performance of the Fund and all matters relating to the Fund’s strategy;
The chief executive officer shall be an ex-officio member of the Board. Working with the Board to provide coherent leadership to the Fund.
Ensure that the Fund has an effective management structure including succession plans.
Establish, direct and manage the NHIF’s managerial, financial, and operational systems, procedures, and controls to ensure that they are professional, workable, and sustainable to enhance value;
Foster a conducive corporate culture that promotes strong ethical practices, good governance, and employee satisfaction;
Promote values and principles as spelt out in Articles 10 and 232 of the Constitution of Kenya in the operations of the Fund;
Any other responsibilities as the Board may determine from time to time to be necessary to achieve Fund’s objectives.

Recognized Qualifications
The NHIF Act stipulates that a person is qualified for appointment as a chief executive officer if the person –

has at least a master’s degree from a university recognized in Kenya.
has at least ten (10) years' experience at a senior management level with skills in health insurance, health financing, financial management, health economics, healthcare, administration, law or business administration.
has a Certificate in Corporate Governance/leadership from a recognized institution.
demonstrates a clear understanding of the NHF Act and all other regulations affecting the Fund
be a member of a professional body in good standing; and
meets the requirements of Chapter Six of the Constitution of Kenya

Key Competencies & Skills
successful candidate must demonstrate.

Strong strategic Leadership skills
Customer Centricity
Business Transformation/Turnaround
Financial and Investment Risk
Strategic Partnerships and Stakeholder Management
People, Culture and Change Management
Proficiency in Computer Applications more