- Coordinates GoHealth/GSCHMA on enrolment, claims, provider payment and financing barriers
- Location: Gombe
- Hiring Responsibility: KSDF
Management Advisor – Health Financing and Insurance
| Source | Partner-supported |
| Institutional location | Commissioner-level DMU; primary interface with GoHealth / GSCHMA |
| Reporting / accountability | Reports to the Senior TA / SDIU Stand-up Lead |
| Nature of role | Embedded, time-bound technical assistance |
| Key working relationships | GoHealth / GSCHMA, Health Financing TWG, DIU, Senior Programme Analyst, Ministry leadership and Finance as required |
Background
The Gombe State Delivery and Insights Unit (SDIU) aims to strengthen the state’s existing health-system architecture by creating a consistent mechanism that connects data, management decisions, coordinated implementation, follow-up and escalation. The SDIU works to strengthen existing statutory functions and connect them into one repeatable evidence-to-decision-to-action cycle. it will connect leadership structures, technical forums, delivery agencies and data systems into one government-led decision-to-action mechanism. The SDIU is not intended to operate as a parallel programme management unit, replace existing government institutions, duplicate technical committees, or assume responsibility for programme implementation.
Role purpose
To translate GoHealth/GSCHMA information on enrolment, claims, provider behaviour, purchasing and financial access into actionable management issues and support follow-through on decisions affecting service access and provider performance.
Key responsibilities
1. Interpret financing and insurance performance
- Review enrolment, beneficiary, provider and claims trends with GoHealth.
- Monitor rejected/returned claims, turnaround times, provider response, beneficiary complaints and access barriers.
- Link financing information with DIU analysis of facility performance and service utilization.
2. Diagnose financing-related barriers
- Identify where low utilization may be related to insurance coverage, affordability, provider readiness or referral constraints.
- Support follow-up on vulnerable-population coverage and hard-to-reach populations where data permit.
- Ensure financing indicators are interpreted alongside programme and service-delivery performance rather than as stand-alone metrics.
3. Coordinate and track action
- Track financing-related TMT decisions and dependencies involving GoHealth, providers, Ministry departments or Finance.
- Coordinate closely with the Health Financing TWG without duplicating its technical mandate.
- Escalate cross-institutional constraints only where normal GoHealth or TWG processes cannot resolve them.
Key deliverables
- Monthly financing/access exception brief.
- GoHealth-related decision and action tracker.
- Quarterly synthesis linking insurance performance to service utilization and provider performance.
- Escalation notes for financing bottlenecks requiring TMT intervention.
Suggested performance indicators
- Proportion of priority GoHealth issues linked to clear corrective actions.
- Reduction in unresolved cross-institutional financing bottlenecks.
- Increased use of GoHealth information within integrated TMT review products.
Recommended profile / capabilities
- Experience in health financing, strategic purchasing, insurance, provider payment or public-sector financing.
- Minimum 7 years of relevant professional experience in health financing, health insurance, healthcare management, health economics, financial management and health-system strengthening.
- Strong understanding of provider and beneficiary workflows.
- Ability to interpret financial and service-utilization data together.
- Experience working with Gombe state health systems preferred.
- Demonstrate experience working with government health-financing structures .
- Strong experience in programme implementation, performance management, and stakeholder coordination.
- Experience working with senior government officials and multidisciplinary technical teams.
- Strong written, analytical, organizational, and communication skills.
