JOB DESCRIPTION

D

Non Family with Residential Location

Non Family with Residential Location

Addis Ababa,Eth Fed Dem Rep

GS6

General Service

Reason

Regular > Regular Assignment

2025-09-01

August 2, 2025

Medical Insurance Associate

Organizational Setting and Work Relationships

Under the direct supervision of the Medical Insurance Officer, the Medical Insurance (MI) Associate will provide advice and guidance on all Medical Insurance-related issues and process all medical claims in a timely and appropriate manner for staff within the Area of Responsibility (AoR). The incumbent will be responsible for the enrolment of all eligible staff members and de-enrolment of inactive employees, the collection of the MI contributions and the processing of claims in respect of all MI participants within the AoR. S/he will act as the focal point for all MI-related issues.

All UNHCR staff members are accountable to perform their duties as reflected in their job description. They do so within their delegated authorities, in line with the regulatory framework of UNHCR which includes the UN Charter, UN Staff Regulations and Rules, UNHCR Policies and Administrative Instructions as well as relevant accountability frameworks. In addition, staff members are required to discharge their responsibilities in a manner consistent with the core, functional, cross-functional, and managerial competencies and UNHCR’s core values of professionalism, integrity, and respect for diversity.

Duties

• Administer medical insurance plans for enrolled staff.
• Process medical insurance claims in a timely and efficient manner.
• Act as a focal point and provide accurate information to enrolled staff regarding medical insurance rules and regulations, applicable procedures, reimbursable benefits, the status of claims, etc., give advice and ensure administrative support as required.
• Maintain an appropriate filing system for all MI-related documents.
• Strictly implement the rules and procedures given in the policy on medical insurance administration.
• Settle clinic invoices, as appropriate, to medical service providers.
• Conduct impromptu visits to hospitals to verify the authenticity of claims.
• Assist DFAM/AFS or relevant Finance units in the reconciliation of Accounts Payables and Receivables.
• Consult relevant units and management on matters that require additional clarification and guidance.
• Issue letters of guarantee of payment to hospitals for staff members and dependants as appropriate.
• Dispatch medical reports to the Medical Service.
• Issue travel authorisation for staff members proceeding on Medical Evacuation.
• Support identification of appropriate healthcare and qualified physicians within the AoR.
• Seek clarification discreetly on medical bills that may appear fraudulent or unclear.
• Propose improvements to the work of the MI Team.
• Replace absent colleagues based on the distribution of tasks established within the team.
• Support the identification and management of risks and seek to seize opportunities impacting objectives in the area of responsibility. Ensure decision making in risk based in the functional area of work. Raise risks, issues and concerns to a supervisor or to relevant functional colleague(s).
• Perform other related duties as required.

Minimum Qualifications

Years of Experience / Degree Level

For G6 – 3 years relevant experience with High School Diploma; or 2 years relevant work experience with Bachelor or equivalent or higher

Field(s) of Education

Not applicable.

Certificates and/or Licenses

Business Administration,                  

Office Management,                         

Human Resources Management

(Certificates and Licenses marked with an asterisk* are essential)

Relevant Job Experience

Essential

Relevant previous job experience to the function or in a related field. Excellent computer skills including MS applications (Word, Excel, PowerPoint).

Desirable

Operational knowledge of Workday and medical insurance claim processing systems. Knowledge of administering insurance schemes. Proficiency in French.

Functional Skills

HR-Administration of Staff Contracts and Benefits

IT-MS Office Applications

IT-Computer Literacy

IT-Microsoft Office Productivity Software

(Functional Skills marked with an asterisk* are essential)

Language Requirements

For International Professional and Field Service jobs: Knowledge of English and UN working language of the duty station if not English.

For National Professional jobs: Knowledge of English and UN working language of the duty station if not English and local language.

For General Service jobs: Knowledge of English and/or UN working language of the duty station if not English.

Competency Requirements

Core Competencies

Accountability

Communication

Organizational Awareness

Teamwork & Collaboration

Commitment to Continuous Learning

Client & Result Orientation

Managerial Competencies

Managing Resources

Cross-Functional Competencies

Analytical Thinking

Technological Awareness

Planning and Organizing

All UNHCR workforce members must individually and collectively, contribute towards a working environment where each person feels safe, and empowered to perform their duties. This includes by demonstrating no tolerance for sexual exploitation and abuse, harassment including sexual harassment, sexism, gender inequality, discrimination, and abuse of power.

As individuals and as managers, all must be proactive in preventing and responding to inappropriate conduct, support ongoing dialogue on these matters and speaking up and seeking guidance and support from relevant UNHCR resources when these issues arise.

This is a Standard Job Description for all UNHCR jobs with this job title and grade level. The Operational Context may contain additional essential and/or desirable qualifications relating to the specific operation and/or position. Any such requirements are incorporated by reference in this Job Description and will be considered for the screening, shortlisting and selection of candidates.

– Relevant experience in reviewing, processing, and adjudicating medical claims.
– Proficiency in using insurance-related software and database (eg. Oracle).
– Experience in the coordination with healthcare providers: experience as a Provider liaison: Acting as a liaison between the UNHCR and healthcare providers to verify patient information and coverage.
– Experience as a Provider relations: capacity to build and maintain relationships with hospitals, clinics, pharmacies, and other healthcare providers.
– Experience in process improvement: Leading projects aimed at improving claims processing efficiency and accuracy, and project to improve healthcare access for the staffs.
– Experience in coordinating teams (HR, Admin and Finances) and resources to achieve project goals and objectives.
– As the staff member will be working in the Human Resources Unit, at least 3 years of previous experience in Human Resources management is required.

French

,

,

English

,

,

Operational context

Occupational Safety and Health Considerations:

Nature of Position:

Living and Working Conditions:

 

Additional Qualifications

Skills

HR-Administration of Staff Contracts and Benefits, IT-Computer Literacy, IT-Microsoft Office Productivity Software, Microsoft Office

Certifications

Business Administration – Other, Human Resources Management – Other, Office Management – Other

Competencies

Accountability, Analytical thinking, Client & results orientation, Commitment to continuous learning, Communication, Managing resource, Organizational awareness, Planning & organizing, Teamwork & collaboration, Technological awareness

https://icsc.un.org/Home/SalaryScales

Compendium

Additional Information

Only shortlisted candidates will be contacted.
Shortlisted candidates may be invited to undertake written and or oral test.

This position doesn”t require a functional clearance