| Job Description - Senior International Consultant – Health Financing Information Systems and Provider Payment Analytics (2603377)
| Senior International Consultant – Health Financing Information Systems and Provider Payment Analytics-(2603377)Contractual Arrangement:External consultantContract Duration (Years, Months, Days):6 months## Job Posting:Aug 11, 2026, 9:38:17 AM## Closing Date:Aug 25, 2026, 5:59:00 PM## Primary Location:Ukraine## Organization:EU_UKR WHO Country Office, Ukraine## Schedule:Part-timeIMPORTANT NOTICE: Please note that the deadline for receipt of applications indicated above reflects your personal device's system settings.### Purpose of consultancyThe purpose of this consultancy is to provide senior international technical expertise to strengthen the strategic use of information for health financing and purchasing reforms in Ukraine.Under the overall guidance and supervision of the WHO National Professional Officer for Health Financing, the consultant will advise on health financing information systems, claims analytics, provider payment methodologies and decision-support tools underpinning the Program of Medical Guarantees. This will include technical guidance on claims management, costing and tariff setting, payment simulation, coding quality, provider performance analysis, and implementation of provider payment methodologies such as case-based payment, diagnosis-related groups, capitation and blended payment approaches.The consultant will work closely with WHO technical staff, the national health financing data analytics consultant and national counterparts, providing international expertise, methodological leadership, peer review and capacity building.### BackgroundSince 2015, Ukraine has undertaken fundamental reforms to improve access to health care, strengthen financial protection and move towards more strategic purchasing. The Law on State Financial Guarantees of Medical Services to the Population (2017) established the Program of Medical Guarantees and created the National Health Service of Ukraine as the single national purchaser.Implementation of the Program of Medical Guarantees has generated extensive administrative, contracting and claims data that can support monitoring of service provision, provider performance and purchasing arrangements. At the same time, increasingly sophisticated provider payment reforms require stronger information architecture, claims management, analytical methods and technical capacity.WHO is supporting the Government of Ukraine in strengthening purchasing and provider payment across priority areas, including hospital and surgical care, rehabilitation, primary health care, emergency medical services, mental health and medicines. This work includes development and refinement of service classifications, payment models, tariffs, coding requirements and performance-monitoring frameworks.Effective implementation requires close integration between health financing policy, claims management, costing, information systems and analytics. WHO is therefore seeking a senior international consultant to provide technical leadership on the strategic use of information to strengthen purchasing decisions, payment system design and analytical capacity.### DeliverablesThe consultant will:- Review Ukraine’s health financing information systems, claims management arrangements, provider payment methods, tariff methodologies and coding practices, drawing on relevant international experience. - Develop or refine analytical methodologies, payment algorithms, case-grouping approaches, costing and tariff-setting frameworks, payment simulations and provider performance indicators. - Analyse administrative and claims data to identify utilization patterns, provider behaviour, coding practices, expenditure trends, case-mix variation and potential anomalies. - Translate provider payment methodologies into functional and technical requirements for implementation through the eHealth system and related information systems. - Provide methodological guidance, peer review and quality assurance for WHO analytical work. - Support technical consultations, capacity building and preparation of methodological guidance, reports and technical materials.### Outputs and tasksUnder the overall guidance and supervision of the WHO National Professional Officer for Health Financing, the consultant will:- Assess health financing information and claims-management arrangements supporting purchasing and provider payment under the Program of Medical Guarantees. - Advise on information architecture, minimum datasets, classifications, coding requirements and data-quality controls required for strategic purchasing. - Develop or refine methods for analysing claims data, including service utilization, case mix, provider performance, coding quality, expenditure patterns and payment incentives.- Provide technical guidance on claims submission, validation, adjudication, audit, outlier management and inappropriate coding or billing. - Support design and refinement of provider payment methodologies, including DRGs and other case-mix approaches, case-based payment, capitation, bundled payment and blended models. - Develop or review approaches to patient classification, relative weights, base rates, adjustment coefficients, outlier payments, costing and tariff setting. - Conduct or support payment simulations and budget-impact analyses of proposed payment reforms. - Translate agreed payment methodologies into algorithms, business rules and technical specifications for electronic implementation. - Develop indicators for monitoring provider behaviour, coding quality, payment distribution, efficiency and equity. - Provide senior peer review, methodological guidance and capacity building to WHO analysts and national counterparts. - Prepare technical reports summarizing findings, methodological decisions and recommendations..### DeliverablesDeliverable 1. Health financing information architecture and strategic use of dataA technical assessment and recommendations prepared on the information architecture required to support strategic purchasing and provider payment under the Program of Medical Guarantees.Deliverable 2. Claims management and provider payment analyticsTechnical methodologies and recommendations developed to strengthen the analysis and management of provider claims and support evidence-informed purchasing decisions.Deliverable 3. Provider payment and case-mix methodologiesSenior technical guidance provided for the design, refinement or implementation of provider payment methodologies under the Program of Medical Guarantees.Deliverable 4. Costing, tariff setting and payment simulationTechnical frameworks and analytical models developed or reviewed to support costing, tariff setting and assessment of proposed provider payment reforms.Deliverable 5. Technical specifications for information-system implementationFunctional and technical requirements developed to translate agreed provider payment arrangements into implementable electronic health system and hospital information system functionality.Deliverable 6. Analytical standards, quality assurance and capacity buildingAnalytical standards, peer-review arrangements and capacity-building materials developed to strengthen the consistency, quality and reproducibility of health financing analytics.### Qualifications, experience, skills and languages### Educational QualificationsEssential: Advanced university degree at Master’s level or higher in health economics, economics, statistics, actuarial science, health informatics, public health, health policy, health financing, information systems or another relevant field.### ExperienceEssential- At least 10 years of international professional experience as a health financing specialist designing information solutions for health financing and purchasing and analysing resulting data patterns. - Demonstrated experience strengthening health financing arrangements through the more strategic use of information at country level. - Demonstrated experience advising governments, public purchasers, national health insurance agencies or similar institutions on health financing or strategic purchasing reforms. - Extensive experience working with administrative claims, reimbursement or provider payment data. - Demonstrated experience in the design, implementation or evaluation of provider payment systems. - Experience translating health financing policy and payment methodologies into information-system requirements, algorithms or business rules. - Experience preparing high-quality technical reports, methodological guidance and policy recommendations for governments or international organizations. Desirable- Experience with diagnosis-related groups or other case-mix-based hospital payment systems. - Experience with capitation, bundled payment, prospective payment or blended provider payment systems. - Experience in claims management, claims adjudication, coding quality, fraud or anomaly detection, and provider audit systems. - Experience working with WHO, the World Bank, the European Union or other international organizations and development partners. - Experience working with ministries of health, national health purchasers or social health insurance organizations in multiple countries. - Experience developing or applying costing, tariff-setting, payment-modelling or budget-impact methodologies.### Skills / KnowledgeEssential:- 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.- Strong knowledge of costing, tariff setting, relative weights, base-rate calculation and payment simulation.- Ability to analyse complex administrative datasets and translate findings into practical policy and system recommendations.- Ability to develop functional requirements, payment algorithms and business rules for digital systems.- Excellent analytical, technical writing, presentation and stakeholder-engagement skills. Desirable- Knowledge of coding systems and classifications relevant to provider payment, such as ICD, procedure classifications and DRG groupers. - Familiarity with SQL, R, Python, Stata, SAS or other tools used to analyse large claims datasets. - Experience with business-intelligence and visualization platforms such as Power BI or Tableau. - Knowledge of data governance, interoperability and health information-system architecture.### Languages and level requiredEssential: Expert knowledge of English.### LocationOn-site for insurance purposes only.The consultancy will primarily involve remote desk-based work, online consultations, technical analysis, report preparation, methodological development and capacity-building activities.The consultant may be required to work in-country in Ukraine for specific technical missions, subject to the security situation.### TravelThe consultant is expected to undertake approximately one to two missions to Ukraine, subject to the security situation and WHO travel clearance.Travel costs will be funded separately in accordance with WHO rules and procedures.### RemunerationContract total value: USD 36 000Monthly rate, daily rate and numbers of the days: Daily rate USD 600 for 60 days (part-time)Consultant pay band range: Pay band level CTerms of payment: Payment will be made on a monthly basis after provision of a technical report and approval from the Responsible Officer.### Expected duration of contractTarget Start Date: 20 September 2026Target End Date: 20 March 2027Contract Duration: 6 months### Additional Information:- This vacancy notice may be used to identify candidates for other similar consultancies at the same level.- Only candidates under serious consideration will be contacted.- A written test may be used as a form of screening.- If your candidature is retained for interview, you will be required to provide, in advance, a scanned copy of the degree(s)/diploma(s)/certificate(s) required for this position. WHO only considers higher educational qualifications obtained from an institution accredited/recognized in the World Higher Education Database (WHED), a list updated by the International Association of Universities (IAU)/United Nations Educational, Scientific and Cultural Organization (UNESCO). The list can be accessed through the link: http://www.whed.net/. Some professional certificates may not appear in the WHED and will require individual review.- For information on WHO's operations please visit: http://www.who.int.- The WHO is committed to creating a diverse and inclusive environment of mutual respect. The WHO recruits workforce regardless of disability status, sex, gender identity, sexual orientation, language, race, marital status, religious, cultural, ethnic and socio-economic backgrounds, or any other personal characteristics. The WHO is committed to achieving gender parity and geographical diversity in its workforce. Women, persons with disabilities, and nationals of unrepresented and underrepresented Member States (https://www.who.int/careers/diversity-equity-and-inclusion) are strongly encouraged to apply for WHO jobs. Persons with disabilities can request reasonable accommodations to enable participation in the recruitment process. Requests for reasonable accommodation should be sent through an email to reasonableaccommodation@who.int- An impeccable record for integrity and professional ethical standards is essential. WHO prides itself on a workforce that adheres to the highest ethical and professional standards and that is committed to put the WHO Values Charter (https://www.who.int/about/who-we-are/our-values) into practice.- WHO has zero tolerance towards sexual exploitation and abuse (SEA), sexual harassment and other types of abusive conduct (i.e., discrimination, abuse of authority and harassment). All members of the WHO workforce have a role to play in promoting a safe and respectful workplace and should report to WHO any actual or suspected cases of SEA, sexual harassment and other types of abusive conduct. To ensure that individuals with a substantiated history of SEA, sexual harassment or other types of abusive conduct are not hired by the Organization, WHO will conduct a background verification of short-listed candidates.- WHO has a smoke-free environment and does not recruit smokers or users of any form of tobacco.- Consultants shall perform the work as independent contractors in a personal capacity, and not as a representative of any entity or authority. - WHO shall have no responsibility for any taxes, duties, social security contributions or other contributions payable by the Consultant. The Consultant shall be solely responsible for withholding and paying any taxes, duties, social security contributions and any other contributions which are applicable to the Consultant in each location/jurisdiction in which the work hereunder is performed, and the Consultant shall not be entitled to any reimbursement thereof by WHO.- Please note that WHO’s contracts are conditional on members of the workforce confirming that they are vaccinated as required by WHO before undertaking a WHO assignment, except where a medical condition does not allow such vaccination, as certified by the WHO Staff Health and Wellbeing Services (SHW). The successful candidate will be asked to provide relevant evidence related to this condition. A copy of the updated vaccination card must be shared with WHO medical service in the medical clearance process. Please note that certain countries require proof of specific vaccinations for entry or exit. For example, official proof /certification of yellow fever vaccination is required to enter many countries. Country-specific vaccine recommendations can be found on the WHO international travel and Staff Health and Wellbeing website. For vaccination-related queries please directly contact SHW directly at shws@who.int.- In case the recruitment website does not display properly, please retry by: (i) checking that you have the latest version of the browser installed (Chrome, Edge or Firefox); (ii) clearing your browser history and opening the site in a new browser (not a new tab within the same browser); or (iii) retry accessing the website using Mozilla Firefox browser or using another device. Click the link for detailed guidance on completing job applications: Instructions for candidates |
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