LOCATION: Anywhere in India (Travel to Meghalaya)
About Affordable Quality Health: Affordable Quality Health (AQH) is a not-for-profit entity (section 8 Company), established in India with the primary aim of providing educational services, research skills and knowledge transfer capabilities in disciplines of health sciences and allied streams. Consequently, InOrder, The Health Systems Institute was established to work towards improving health system performances and health outcomes through academics, capacity building initiatives and translational research endeavours. It is a DSIR-recognized centre for evidence generation and evidence synthesis in domains of public health and related domains. InOrder is committed to expand its academic and capacity building activities in disciplines of medicine, public health, nursing, management and social sciences. It has active partnerships with global partners like ACCESS Health International and context-specific collaborations with donor agencies, UN bodies, international organizations, state governments and the government of India.
About The Assignment
Affordable Quality Health is supporting evaluation of a Meghalaya Health Insurance Scheme towards redesigning the state health insurance schemes with following objectives.
- Scheme Evaluation – assess current MHIS performance, utilization and financial sustainability
- Coverage Expansion – evaluate feasibility of inclusion of government employees & pensioners and their dependents
- Develop premium-sharing mechanisms and evaluate fiscal implications for government and beneficiaries
- Redesign Health Benefit Package (HBP) for cost effectiveness, clinical relevance and improved outcomes
- Design full implementation architecture
Role Overview
The Senior Consultant will lead the design and evaluation of a premium sharing model for state sponsored health insurance scheme focusing on financial sustainability, policy design, and stakeholder alignment. The role requires strong expertise in health financing, insurance modelling, and government advisory.
Key Responsibilities
- Design and conduct financing and stainability assessment of existing premium structure, claims trends and subsidy burden and evaluate financial sustainability and fiscal implications.
- Develop and evaluate fully subsidized models, partial contribution models and income-based / tiered contribution structures.
- Define eligible contributing households and subsidy frameworks
- Conduct financial modelling and scenario analysis to develop claims estimation models, premium scenarios and conduct scenario modelling (no contribution vs partial vs tiered) and conduct sensitivity and risk analysis
- Conduct sustainability & fiscal impact and project 3–5 year financial sustainability.
- Assess government liability under different scenarios and compare with vs without premium sharing
- Suggest financial, social, and operational feasibility assessment
- Design and monitor social and behavioral analysis to understand willingness to pay, enrollment elasticity, drop out risk assessment to identify acceptable contribution levels and risk of exclusions and integrate social and behavioural insights into policy design
- Lead consultations with Government departments (Finance, Health, SHA) to test acceptability of contribution and operational feasibility
- Develop final policy recommendation and implementation roadmap
Deliverables
- Financing assessment & sustainability baseline
- Contribution model design note
- Financial model & scenario outputs
- Sustainability projections
- Feasibility assessment report
- Final policy recommendation & implementation roadmap
Required Experience & Qualifications
- 8–15 years of experience in Health financing / insurance / public policy
- Proven experience in Premium modelling and actuarial analysis
- Government health schemes (PM-JAY / State schemes preferred)
- Strong analytical and problem-solving skills
- Qualification:
- Masters in Public Health / Health Economics / Public Policy / Finance
Key Skills
- Financial modelling and scenario analysis
- Policy design and advisory
- Stakeholder engagement
- Strong communication and report writing
Scope Of Work – Premium Sharing Mechanism & Fiscal Impact Assessment (MHIS Phase 7)
Objective: To design a sustainable, equitable, and implementable premium sharing mechanism by assessing financial, social, and operational feasibility for MHIS-7
Deliverables
- Financing assessment & sustainability baseline
- Contribution model design note
- Feasibility assessment report (financial, social, operational)
- Financial model & scenario outputs
- Social & behavioural analysis report
- Benchmarking report (India + international)
- Sustainability projections
- Final policy recommendation report
Period Of Contract
(May- July 2026)
HOW TO APPLY: Eligible and interested candidates may email the latest Resume (in PDF format only) to <careers@inorder.in> mentioning name of the position in the ‘Subject Line’ of the email. Last date for application is 20th April, 2026.