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
For more of the latest jobs, please visit http://www.theugandanjobline.com or
find us on our facebook page https://www.facebook.com/UgandanJobline




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