06 September 2016

Claims and Settlements Manager (Medical Doctor) Job Vacancy - PricewaterhouseCoopers (PwC)

Organisation: PricewaterhouseCoopers (PwC)
Duty Station: Kampala, Uganda
Reference Number: 129-UGA00019

About PwC:
PricewaterhouseCoopers (PwC) supports organisations and individuals create the value they’re looking for. We’re a network of firms in 157 countries with more than 208,000 people who are committed to delivering quality in assurance, tax and advisory services. Our purpose is to build trust in society and solve important problems. Our in-depth knowledge and understanding of operating environments in Uganda and the region enables us to put ourselves in our clients’ shoes and offer truly tailored Tax, Assurance and Advisory solutions to unique business challenges.

About Voucher Plus Project:
Abt Associates has sub-contracted PwC as the Voucher Management Agent (VMA) that will manage the entire cycle of the voucher program from printing and distribution of vouchers to partners, contracting of Voucher Service Providers (VSPs), redemption of vouchers and payment of authenticated claims to VSPs. Uganda Voucher Plus Activity is a 5 year maternal health voucher program. The program will distribute approximately 385,000 vouchers to poor pregnant mothers in Eastern and Northern Uganda.

Job Summary: The Claims and Settlements Manager (Medical Doctor) will be tasked with assessing the validity of claims from a broader technical (including medical) perspective. This will be achieved by providing a supervisory role to the claim vetting officers and data entrants.

Key Duties and Responsibilities: 
Management of voucher activity stock:
·         On receipt of printed vouchers from printer, verify that vouchers have been printed as per specifications
·         Scan all verified printed vouchers and enter them in the Voucher Management Information System (VMIS) and store them in voucher storage/warehouse
·         Issue vouchers to Community Engagement Agent (CEA) and maintain accurate record of issues
·         Regularly track vouchers sold in the VMIS
·         Maintain up to date and accurate records in regards to voucher stocks
·         Reconcile vouchers sold to income declared
Management of Voucher Service Provider (VSP) claims:
·         Review and print off vetted claims from the VMIS for VSP payment processing
·         Ensure VSP claims are regularly reconciled
·         Ensure that VMIS is continually updated to facilitate efficient processing and reporting on VSP payments.
·         Regular review of investigation reports of all quarantined claims and gather sufficient evidence to subsequently approve or reject the claim
·         Work in liaison with the entire Voucher Management Agent team and VSPs to facilitate an effective and efficient payment process
·         Supervising data entrants and claims vetting officers including reviewing their work
·         Generate processed claims report with clear guidance on which claims to process for payments and which ones to reject
·         Keenly monitor for patterns and reoccurrences of claim anomalies and identify capacity gaps in VSPs’ knowledge and claims reporting
·         Recommend areas for follow-up during field spot checks/ verification and actively participate in spot reviews as will be guided from time to time by the Project Coordinator
·         Carry out periodic analysis of claims data and generate reports as needed
·         Perform any other duties as will be assigned by the Project Coordinator from time to time.

Qualifications, Skills and Experience: 
·         The ideal candidate for the Claims and Settlements Manager (Medical Doctor) job must hold a Bachelor’s degree in medicine
·         Possession of a Master’s degree in Obstetrics & Gynaecology or public health will be an added advantage
·         Broad knowledge and extensive clinical experience of at least 3 years in comprehensive obstetric care and reproductive health issues
·         Excellent track record of delivering results as a team in a project of a comparable size, scope and complexity
·         Previous experience in use of computer applications
·         Good teamwork and leadership skills

How to Apply:
If you are confident that you fit the person and job profile and you are keen on growing your career with one of the leading Consultancy firms in the Country, please visit our Careers website.

Deadline: 8th September 2016

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