Senior International Consultant - Health Financing Information Systems And Provider Payment Analytics

Organizational Context

Ukraine has been undergoing significant health reforms since 2015, including the establishment of the Program of Medical Guarantees and the National Health Service as the single national purchaser. This reform generates extensive data for monitoring and requires sophisticated information systems and analytical capacity for effective implementation. WHO supports these efforts by strengthening purchasing and provider payment mechanisms.

Job Purpose

This senior international consultant role is crucial for advancing Ukraine's health financing reforms by providing technical leadership on the strategic utilization of information. The purpose is to enhance purchasing decisions, refine provider payment system design, and build analytical capacity. The consultant will leverage extensive data generated from reforms to improve health care access, financial protection, and strategic purchasing, ensuring effective integration of health financing policy, claims management, costing, and information systems. This position directly contributes to strengthening the national health system's analytical capabilities and operational efficiency.

Responsibilities

The consultant will review Ukraine's health financing information systems, claims management, and provider payment methods, drawing on international best practices. Key duties include developing and refining analytical methodologies, payment algorithms, and costing frameworks; analyzing administrative and claims data to identify utilization patterns, provider behavior, and expenditure trends; and translating payment methodologies into functional requirements for eHealth systems. The role involves providing methodological guidance, quality assurance for analytical work, supporting technical consultations, and building capacity among WHO staff and national counterparts. Specific tasks include advising on information architecture, data quality controls, developing methods for claims data analysis, guiding claims submission and validation processes, supporting the design of provider payment methodologies (e.g., DRGs, capitation), and developing indicators for monitoring provider performance and payment distribution.

Work Experience

Requires at least 10 years of international professional experience as a health financing specialist, with a focus on designing information solutions for health financing and purchasing, and analyzing resulting data. Essential experience includes strengthening health financing through strategic information use, advising governments on reforms, extensive work with claims and provider payment data, and experience in designing or evaluating provider payment systems. Experience translating policy into system requirements is also crucial.

Skills

Expert knowledge of strategic purchasing, provider payment systems, and health financing information systems. Strong understanding of claims management, case-mix classification, DRGs, and prospective payment. Proficient in analyzing complex datasets and translating findings into policy recommendations. Ability to develop functional requirements, algorithms, and business rules for digital systems. Excellent analytical, technical writing, presentation, and stakeholder engagement skills. Knowledge of coding systems (ICD, DRG groupers) and data analysis tools (SQL, R, Python) is desirable.

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