National Technical Assistant
Position Circumstances
- Career Category: Assistant, Health/Medical, Advisor / Individual Consultant
- Schedule:Full-time
- Salary: N/A
The Consultant for Claim Review Protocol Improvement
Duty Station and Contract Duration:
The Consultant is based at NPCA, with frequent travel to provinces to carry out assigned tasks. The contract is hired for Full-time with a working period of 12 months, starting from the commencement date, with the possibility of extension. The extension of the contract is subject to the consultant’s performance, availability of funds, and the Project’s needs. The Director of Department will assign other tasks.
Administrative Details
- Reporting: Reports directly to the Director of the Payment Certification Department.
- Duty Station: Based at NPCA Headquarters in Phnom Penh with frequent travel to provinces as required.
- Performance Review: Subject to quarterly performance assessments.
- Period of assignment: 12 months, and subject for extension based on proficiency and work effectiveness.
Duties & Responsibilities:
- Key responsibilities
- Strategic Review: Evaluate existing digital claim management processes and provide technical guidance for the transition toward full automation.
- Logic Integration: Convert complex clinical protocols into technical logic and algorithms for integration into Rule-based Engine.
- ICT Coordination: Collaborate closely with NPCA ICT team to ensure the medical and clinical logic is accurately translated into the digital adjudication software.
- Workflow Optimization: Identify bottlenecks in current certification workflows and propose automated solutions to streamline claim processing.
- Expected Results
- Standardized Automated Protocols: Comprehensive technical documentation and clinical-to-digital logic maps ready for Rule-Based adjudication.
- Enhanced Adjudication Accuracy: A validated set of digital rules that align with national medical guidelines.
Expected Profile of Candidates
Qualifications:
- Master's Degree in Public Health, Health Informatics, or a related medical field
Work History:
- At least of professional experience in the public health or medical field for 7 years
- At least of direct experience at a health insurance institution or in claim adjudication management for 5 years
- At least of experience demonstrating a strong understanding of clinical guidelines (MPA/CPA) for 3 years
Skills & Knowledge:
General & Technical Skills
- At least 2 projects with proven expertise in converting medical guidelines into technical logic/algorithms and familiarity with digital health systems, AI-assisted tools are highly desirable.
- Good technical report writing and experience in developing regulatory framework.
- Fluency in written and spoken Khmer and English, with strong report writing, presentation, and interpersonal communication skills.
