| 1. |
Chief Executive Officer |
- The Chief Executive Officer (CEO) will look after all the operational aspects of the implementation of the scheme and shall be supported by a team of specialists (dealing with specific functions).
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| 2. |
Policy Manager |
- Responsible for reviewing program guidelines prepared for SHA, analyzing these documents for consistency and synergy
- Ensure activities adhere to agreed guidelines; provide overarching support to SHA and Districts.
- Undertake periodic field visits to districts to review implementation of the scheme in the States, identify implementation challenges and support SHA in charting appropriate solutions or enable linkages with appropriate institutions for technical inputs in the state
- Provide technical inputs on thematic areas of Health Financing and Health Protection
- Undertake analytical documentation of field review visits to inform improvements in implementation CEO, State Health Agency Rs. 1.25 lakhs – Rs. 1.50 lakhs per month
- Identify best practices and innovations within state and support SHA in expanding these.
- Technical assistance for planning & strengthening systems in the poor performing districts
- Building capacities at district and state level for effective implementation of the scheme.
- Develop study / evaluation protocols and undertake and guide studies as needed.
- Mobilizing technical assistance inputs for the SHA and districts, including preparation of Terms of Reference, inviting proposals application etc.
- Undertake review of literature and stay up-to-date on current trends in health financing.
- Collect and analyze state and national data on components of health financing on a regular basis
- Provide periodic synopsis of progress in districts using data and field findings as a means of technical support and program oversight
- Grievance redressal
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| 3. |
Operations Manager |
- Operations Manager(s) will provide overall support to CEO, SHA in implementation of AB-NHPM in the state.
- Ensure compliance of operational processes and procedures as per guidelines of AB-NHPM
- Ensure the activities for effective alliance of the State health insurance scheme (if any) and AB-NHPM.
- Ensure seamless internal and external communication
- Supervises the operations at the state level including timelines for the activities of the AB-NHPM.
- Overseeing beneficiary data management, Aadhaar seeding, validation, awareness, monitoring, audit, training etc.
- Maintaining the quality and timeliness of the utilization data, reporting MIS, premium and claim payments etc.
- Random reviews of pre-authorizations and claims
- Work with the teams across functions and other stakeholders to ensure smooth flow of data to state level on a periodic basis
- Organize routine, periodical and surveillance visits to the entities participating in the scheme to ensure that all processes are running as per defined standards
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Claims Audit
- Carry out claims audit on random basis
- Carry out random checks, visits and investigations pertaining to admissibility of the cases paid or declined under the scheme
- Supervising district teams and facilitating them in performing their duties.
- Co-ordinating with PMUs of other health programmes operation in the State for effective horizontal integration.
- Fraud and abuse control
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| 4. |
Finance Manager |
- Finance Manager is primarily responsible for overseeing the funds management under SHA and monitoring overall financial management including release of funds, expenditure, reporting, Statutory Audit, Utilization Certificates, field review visits etc.
- Supervision, monitoring, training and guidance of the team at state and district levels
- Devise financial management information system
- Submit periodic financial report to NHA
- Statutory Audit arrangements for State; monitoring, review, analysis, compliance of Audit and GOI observations and timely submission of Audit Reports
- Capacity building for State/District level finance & accounts staff from time to time
- Act as Nodal Officer for all Finance, Accounts and Audit matters
- Provide information/data support for Parliament Questions/Committees, RTI, VIP references, CAG audits etc. from time to time
- Monitoring financial performance indicators and convergence of financial & accounting processes
- Visits to districts for financial management performance review, financial studies and prepare status reports with recommendations for improvement
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| 5. |
IT Support and Data Manager |
- Helping hospitals and implementing agencies (insurer/ISA) with use of the information system
- Ensuring uptime of hardware and software, availability of data, integrity & security of data
- Understand the software functional requirements for the smooth functioning of the scheme.
- Overall supervising and managing IT tasks for implementation of the scheme
- Maintaining high standards of Quality of process documentation and implementation
- Participate in the meetings convened with senior officers of the state
- Oversees troubleshooting, systems backups, archiving, and disaster recovery and provides expert support when necessary
- Work with the teams across functions and other stakeholders to ensure smooth flow of data to Dashboard on a periodic basis
- Ensuring data security and implementation of access protocols for data as defined by senior management
- Ensures the IT updates are communicated to all the relevant stakeholders and appropriate training is provided to ensure ease of usage
- Support enrolment activities and fraud control
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| 6. |
IEC Manager |
- Develop guidelines for IEC/BCC Program for the scheme, keeping in view the evidence (data) based rationale, background work already undertaken, innovations etc.
- Coordinate with the verticals of SHA and analyze need for IEC/BCC; this should be reflected in the guideline for the IEC/BCC program
- Develop Media Plans for mass media campaigns, social media campaigns.
- Advise on the appropriate mix of materials to be developed as per the specific request for the communication campaigns and facilitate creating prototypes / artworks for the same
- Review available formative research to develop, guide the development/modification/adaptation of the communication materials
- Identify and undertake the creative development of key messages that need to be included in communication materials for concerned campaigns.
- Organize review of IEC/BCC activities.
- Coordinate development of creative graphics and content suitable for social media
- Coordinate development of the following: annual report, e -book, newsletter, reports etc.
- Coordinate with print and electronic media to organize press briefings and subsequently prepare and disseminate press releases
- Manage and oversee the work of agencies contracted for the development of communication campaigns / materials, if needed. This includes guiding as well as overseeing aspects related to creative content development / treatment, graphic design and layout
- Make IEC/BCC Repository available online
- Support in organizing IEC and enrolment activities
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| 7. |
Accounts Assistant |
- The Accounts Assistant shall help the Finance Manager in conducting internal audit, fund management, and cash flow management of the SHA.
- Monitor accounts receivable and payables to ensure acceptable turnaround time
- Coordinates and provides inputs in preparation of budget for state NHPM.
- Conduct variance analysis to determine difference between projected & actual spend and formulate / implement corrective actions for the year.
- Manage corpus and funding of the trust
- Manage accounts and bills, including payments to providers.
- Play instrumental role in development and management of monthly monitoring and control framework
- Coordinate with districts to obtain relevant data on time
- Managing the timely preparation and audit of statutory books of accounts, financial statements and annual reports, ensuring conformance to regulatory accounting standards
- Conduct trend analysis of claim payments on a Year on Year basis and highlight any anomalies
- Overall supervise and manage finance & admin processes
- Participate in the meetings convened with senior officers
- Ensuring timely filing of any applicable tax returns & interfacing with Auditors and regulatory authorities for assessments and remittances
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| 8. |
Peon |
- Carrying files and documents from one office to another.
- Helping in office maintenance, like opening/closing the office, arranging furniture, cleaning desks (minor cleaning).
- Serving water, tea, refreshments to officials and guests.
- Assisting in photocopying, scanning, or basic paperwork tasks.
- Maintaining office equipment (like ensuring printers have paper, etc.).
- Delivering official letters to nearby offices or post offices.
- Guiding visitors or escorting them inside office premises.
- Supporting during meetings by arranging chairs, papers, or refreshments.
- Assist in managing files related to beneficiaries, carrying records between departments, or supporting event setups like health awareness workshops.
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