Consultant – Technical Support to the Bauchi State Healthcare Contributory Management Agency (BASCHMA) at Palladium Group

Palladium is a global leader in the design, development and delivery of Positive Impact – the intentional creation of enduring social and economic value. We work with foundations, investors, governments, corporations, communities and civil society to formulate strategies and implement solutions that generate lasting social, environmental and financial benefits.

We invite applications for the position below:

Job Title: Consultant to Provide Technical Support to the Bauchi State Healthcare Contributory Management Agency (BASCHMA) to Ensure Effective Implementation of the State Health Insurance Scheme and Access to Quality Health Services for the Beneficiaries

Subject RFP #: TO3 1.2.9 RFP_Health Insurance Expert Consultancy

Location: Bauchi

Purpose

  • Palladium invites applications from suitably qualified individual consultants to provide technical and capacity building support to the Bauchi State Contributory Health Management Agency (BASCHMA) in operationalizing its Scheme.
  • In this Request for Proposal, Palladium expects offerors to develop a custom solution and proposal to Palladium for consideration. Bidders are required to provide justification for the work proposed or methodology to be adopted. This will be a Best Value procurement.

Project

  • The Integrated Health Program (IHP) is a USAID-funded five-year project with a mandate to improve health systems, improve access to and increase quality of primary health care in designated states (Sokoto, Bauchi, Kebbi, Ebonyi and FCT).
  • IHP is working with state governments to strengthen and advance operationalization of State Health Insurance Schemes toward attainment of universal health coverage.
  • IHP aims to improve the enabling environment for equitable and sustainable health services, supplies, and delivery systems through policy development and implementation, with an emphasis on voluntary, rights-based health programs.
  • IHP will help public health and policy leaders attach higher priority to their national and sub-national health needs, secure sustainable financing, advance health equity, and monitor policy implementation to ensure gains stay on track.
  • IHP aims to secure long-term enduring change by working with coalitions both inside and outside of health and showing common cause with neglected populations and other development actors.
  • Central elements of IHP revolve around building in country capacity, institutionalizing achievements of past investments, and promoting country ownership of programs and initiatives.
  • The decentralization of the National Health Insurance Scheme (NHIS) and consequent establishment of State Health Insurance/Contributory Schemes (SHIS) across the country is one of the key policy thrusts of the Government of Nigeria aimed at reforming the health financing landscape for a stronger health system and improved health outcomes. To this effect, IHP is supporting focal states to put in place necessary design elements and operational structures for the effective roll-out and implementation of the various state contributory health schemes (SCHS).

The Bauchi State Contributory Health Agency (BASCHMA)

  • The Bauchi State Contributory Health Agency (BASCHMA) was aet up in 2017 to implement the Bauchi Contributory Health Scheme (BACHES) which is expected to achieve Bauchi state’s residents’ financial access to quality health care services.
  • At present, BASCHMA, with the support of the USAID-IHP project, has designed the technical elements and operational processes required to operationalize the Scheme. These include a costed benefit package, operational guidelines on health insurance processes such as enrolment, TPA engagement, claims management and quality assurance.
  • BASCHMA has formally agreed with labour unions and associations to commence formal sector deductions from January 2021 and wishes to conduct enrolment of the formal sector in the first quarter of 2021 and commence service provision no later than 1 April, 2021.
  • In support of this objective, USAID-IHP now wishes to continue to support BASCHMA in implementing the designed technical guidelines and standard operating procedures and build the staff’s capacity to manage health insurance operations.
  • In addition, as BASCHMA commences formal sector coverage, USAID-IHP will provide technical support to expand coverage to the informal sector and enhance the Scheme’s ability to collect, analyse and use encounter and claim data to enable strategic decision making.
  • USAID-IHP is seeking a qualified consultant to be embedded within BASCHMA to provide guidance on the implementation of health insurance technical operations and to build the team’s capacity to progressively take on these activities.

Type of Contract:

  • This is a firm fixed price deliverable-based contract. The consultant is expected to satisfactorily accomplish the deliverables before he/she gets paid for that deliverable.
  • The IHP Chief of Party reserves the right to confirm if a deliverable is delivered adequately or otherwise.
  • No price change is expected after contract is signed. IHP will not pay for cost of any deliverable that is not complete, of quality and delivered on time.

Anticipated Contract Term:

  • The anticipated performance period for the consultancy is April 20, 2021 to July 20,2021.
  • As a firm fixed price consultancy based on deliverables, Palladium will only pay for deliverables that have met the standards and expectations of the program and which is also delivered within assigned timelines.

Timeline

  • Applications are expected to be submitted on or before the due date as appears on the cover page.
  • Applications received will have a validity period of six months.
  • Palladium will set up an evaluation committee who will meet to review all applications received within two weeks after the application period has closed.
  • Top candidates may further be invited for an interview by the evaluation committee which will be conducted a week after the first evaluation.
  • Depending on availability of the members of the evaluation committee and the exigences of the program, evaluation may be conducted at times which may be shorter or longer than stated here.
  • Palladium will most likely issue the contract to the successful contractor from this process within 30 to 60 days after submission. Palladium’s ability to issue such contracts may be contingent upon USAID approval and when donor approval is required, timelines for contract award may be longer than stated.
  • Palladium hopes that the services to be rendered on this consultancy will commence on April 1, 2021

Scope of Work and Standards

Background:

  • The implementation of the State Health Insurance Scheme in states is an essential mechanism for ensuring improvement in attaining Universal Health Coverage (UHC) in the country.
  • These schemes will ensure a stable, predictable, and sustainable source of funding for health.
  • Additionally, the successful implementation of the schemes will ensure universal access to quality, equitable care especially to reproductive health/family planning, maternal health, newborn health, child health, nutrition, and malaria services.
  • There is a need to build technical capacity to implement and manage these schemes at the state level, and therefore it is essential to strengthen operational and technical capacity of BASCHMA to implement efficient and effective health insurance operations that will ensure coverage and protection to a large proportion or the populace.

Roles and Responsibilities:

  • The consultant will provide technical support for streamlining the Bauchi Health Contributory Scheme’s operations and ensuring necessary structures and processes are in place to guarantee delivery of services to enrolees, facilitate expansion to the informal sector, improve quality processes and build capacity of BASCHMA staff to manage the scheme.
  • The consultant is required to be embedded with the BASCHMA team in their state office(s) for the period of the consultancy.

Services Description:

The major products and outcomes of this assignment are:

  • Review and, where applicable, update Guidelines, Standard Operating Procedures and Tools that are needed for BASCHMA’s operations
  • Support BASCHMA with the set-up of efficient enrolment processes for both formal and informal sector and develop an up to date enrolment database which aggregates, analyses and reports enrolment data from various enrolment points
  • Provide technical assistance to BASCHMA to identify/develop informal sector aggregators/platforms/ structures that can be leveraged for health insurance enrolment and develop an informal sector action plan to achieve target informal sector coverage
  • Support the institution of a claims review, adjudication, and payment process for BASCHMA
  • Build the BASCHMA’s staff capacity on managing health insurance operations through a mix of on the job training, mentorship, and engagement in implementation of technical and operational documents. Support with troubleshooting and resolving issues encountered in implementing health insurance operations
  • Provide support to the Executive Secretary, BASCHMA in facilitating the execution of BASCHMA’s 2021 Annual Operating Plan and driving a culture accountability and performance within the Agency

The Consultancy will run for a period of three (3) months and the consultant is required to be embedded within BASCHMA for the period of this consultancy

Deliverables

The major products and outcomes of this assignment are:

  • A web-based enrolment database, with functionality for analysis and dashboard reporting developed and active.
  • At least one cycle of claims review conducted with defined triggers for querying claims, investigation of queried claims and analysis of impact of claims reimbursement trends on utilization and pricing of services
  • Informal sector enrolment plan with clear assigned tasks, targeted groups/individuals, and timelines developed and costed
  • Staff Capacity Assessment Report, Capacity Building Plan and Agenda, attendance lists, and training materials used for at least 5 capacity building in-house events
  • At least 20% of BASCHMA’s Annual operational Plan implemented during the period of the consultancy
  • The Consultancy will run for a period of three (3) months and the consultant is required to build BASCHMA’s capacity to progressively take on the activities within this scope of work

Eligibility Requirements

The consultant must possess the following core competencies:

  • A good First Degree or its equivalent from a reputable University in Medicine, Sciences, or Numerate disciplines such as Actuarial Science, Statistics, Insurance, etc.
  • Post graduate qualification in Management, Public Health, Health Management, Health Economics, Insurance, or other related fields
  • Certification in and/or professional membership of Health, Management and Health Insurance related bodies shall be an added advantage
  • Minimum of 7 years’ experience implementing health insurance in Nigeria or related settings.
  • Expertise in claims management and reimbursement best practices
  • Experience in developing and delivering capacity building workshops; including on health insurance implementation
  • Experience in contributing to the development of health insurance strategic plans and managing teams to implement health insurance strategic plans
  • Good understanding of current health financing reform initiatives in Nigeria especially the subnational level
  • Experience carrying out similar assignments in Nigeria particularly at the sub-national level.

Required Technical Competencies:

  • Good interpersonal skills with emphasis on communication, multi-stakeholder coordination, respect and negotiation
  • Good leadership skills
  • Proficient in the use and application of computer and mobile technology, database tools and Microsoft packages (Word, PowerPoint, Excel, Internet Explorer).

Application Closing Date

6th April, 2021 at 11.59pm (WAT).

How to Apply

Interested and qualified candidates (Bidders) are expected to submit both Technical and Financial Bids and in two separate emails to: [email protected] stating as part of the subject matter of the email whether “Technical Bid” or “Financial Bid” and also quoting the RFP number as it appears on the Cover page.

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Note: No late application will be received after the deadline.

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