Position Title Senior Risk Equalization Specialist
Reports to (Position) Head of Finance and Actuary
Manages (No of Direct Reports)
The Senior Risk Equalization Specialist is one of the senior positions in the Company. The incumbent will advise and report directly to the Head of Finance and Actuary of the Health Financing and Insurance Department which oversee.
The Risk Equalization Specialist will be responsible for ensuring that no risk rating or risk selection is practiced by Private Health Insurers .
The core task of the Risk Equalization Specialist will be a diverse portfolio of responsibilities, all related to the key objective of ensuring that the performs effectively and efficiently and that is taking appropriate, optimized regulatory interventions
Nature and Scope of Position:
1. Must be well versed with the equivalence principle and premium adjustments as per the risk profile.
2. Excellent knowledge of risk rated premiums across groups and sub-groups.
3. Knowledge of Premium subsidization rate variation and risk subset factors.
4. Must be able to manage and overlook Risk Equalization Fund.
5. Must ensure that the risk adjusted subsidizes are aligned with the policy goals.
6. Ensure the effectiveness of risk adjusted premium subsidies by implementing monitoring and evaluation tools.
7. Must present regulation and policies to and for improving the subsidies with profit /loss predictability.
8. Excellent knowledge of Diagnosis based risk adjustments, with alignment of weights with normative cost.
9. Knowledge of health status measurements scales and validity testing.
10. The Risk Equalization Specialist is responsible for the following:
11. Overseeing the design and implementation of sound risk equalization mechanism, design risk equalization processes and procedures across the SHIS to maximize process efficiency and premium optimisation.
12. Overseeing the implementation of policies necessary for setting the health insurance premiums through actuarial analysis.
13. Ensuring that no risk selection is practiced
14. Designing and developing specific ongoing and one-time data requirements needed to perform analyses to support risk equalization mechanism development
15. Participate in the development of proposed policy relating to and across , based on the robust analysis of qualitative and quantitative evidence. When appropriate, this will also involve drawing on international best practice.
16. Conducting both planned and ad-hoc research into performance or regulatory issues arising from regular analysis of quantitative and qualitative system information, to support policy or regulatory development;
17. Leading the evaluation of both quantitative and qualitative performance information gathered
18. Assisting the Head of Finance and Actuary in reviewing priorities, and spending against those priorities;
20. The Specialist will be expected to fulfill these duties with passion, commitment and professionalism.
22. The Risk Equalization Specialist will also be expected to sit on expert panels when required, attend and present at public events, engage with colleagues from other teams across , communicate with leads from other regulatory bodies (such as the QCB, QFCRA … etc.) and undertake strategic projects in partnership with other department heads within the Regulator.
23. To lead the development of and assess the risk rating and risk selection for underwriting;
24. To ensure high-risk persons (elderly, disabled and different population categories entitled to government subsidy as specified by the Law and its Implementing Regulation) pay their premium partly with government subsidy and partly by their employer or sponsor. The subsidies may be earmarked for the purchase of specified insurance coverage.
25. To lead the drafting of the annual financial report of the Scheme;
26. To lead the scoping, development and drafting of major qualitative and quantitative research programmers;
27. To prepare and present report when required
28. To work closely with other members of the senior management team to ensure a consistent approach to regulation;
29. To form and maintain relationships with regulated bodies or prospective regulated bodies, and to be a representative of the NHIS at public events, conferences and seminars; and
30. To form and maintain relationships with senior members of other regulatory agencies across the country.
31. The incumbent will be making local and international phone calls during and outside of the working hours, as necessary in order to facilitate and expedite outcomes.
32. The incumbent will be attending meetings, conferences and workshops, and give presentations to address any issue related to his/her job, whether within the premises or in any locations within Qatar, or even internationally.
|Job Location:||Doha, Qatar|
|Job Role:||Support Services|
|Company Industry:||Healthcare, other|
|Monthly Salary:||US $5,000|
|Career Level:||Mid Career|
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