Claims Assurance Associate - Maternity Cover

Maisha Meds is hiring! We’re looking for an Assurance Associate - Maternity Cover to help safeguard program integrity through accurate claims review, verification, and fraud detection.

About Maisha Meds

Maisha Meds is an organization dedicated to improving health care in Africa through best-in-class technology.

Founded in 2017, Maisha Meds has created the largest digital network of private pharmacies and clinics across Kenya, Tanzania, Uganda, Nigeria, and Zambia through our mobile software.

Our platform not only helps these providers improve business by making sales, managing inventory, and tracking patients. It also reimburses them for providing high-quality care for malaria, family planning, and HIV prevention at discounted costs.

Maisha Meds logs millions of patient visits every year and has provided hundreds of thousands of reimbursements to date. We harness data from our network of pharmacies and clinics to reveal health and market trends, which allows us to design better solutions that work for the people we serve.

We have worked with leading academic institutions such as UC Berkeley, Emory University, and KEMRI to evaluate the effectiveness of our programs. Research shows that our system is able to significantly increase the uptake of long-acting contraceptives and appropriate malaria case management.

Our work is funded by a range of partners, including scale-up funding from USAID Development Innovation Ventures and the Bill & Melinda Gates Foundation.

This will help Maisha Meds greatly expand it's mobile software to 7,500 total pharmacies and clinics by late 2026, delivering subsidized care to nearly a million new patients in the process.

About the role`

We are seeking a highly motivated and detail-oriented Claims Assurance Associate to join our Programs Assurance Team on a fixed-term maternity cover.

This role is critical to safeguarding program integrity by ensuring that program claims are verified accurately, consistently, and in accordance with organizational policies and established quality standards.

The ideal candidate is analytical, exercises sound professional judgment, and thrives in a fast-paced, collegial, and technology-enabled environment while maintaining a strong commitment to accuracy, accountability, and service excellence.

This role is based in Uganda with limited travel to field operations.

You will report to the Assurance Manager and will have no supervisory responsibilities.

The expected start date is September 2026, and compensation is commensurate with experience.

Responsibilities

1. Verify and adjudicate program claims to determine their approval, rejection, or escalation in accordance with organizational policies, program guidelines, and service level agreements.
2. Identify and document non-compliant, high-risk, or potentially fraudulent claims, escalating cases for further investigation as appropriate.
3. Maintain accurate records of claim verifications and decisions, ensuring compliance with quality assurance standards and audit requirements.
4. Contribute to periodic reports by documenting claim trends, operational risks, fraud indicators, and recommendations for process and system improvement.
5. Collaborate effectively with cross-functional teams to resolve claim - related issues and support efficient claims verification processes.
6. Uphold organizational standards on confidentiality, data protection, professionalism, and continuous improvement in claims verification and assurance.
7. Any other roles as may be assigned based on need.
   

Qualifications

1. Academic qualifications: Diploma or Bachelor's degree in a health-related field (Public Health, Pharmacy, or Nursing); candidates with Project Management, Customer Service, or related qualifications shall also be considered.
2. Experience: At least one year of experience in healthcare, health programs, or related environments.
3. Demonstrated experience working effectively in a remote or hybrid work environment with the ability to manage tasks independently.
4. Proficiency or familiarity with productivity and digital collaboration tools such as Google Workspace, Microsoft Office Suite, and Slack.
5. Experience using CRM or case management platforms (e.g., HubSpot) and the ability to quickly learn new digital systems.
6. Strong analytical, problem-solving, and organizational skills with excellent attention to detail and the ability to meet deadlines.
7. High standards of integrity, professionalism, confidentiality, and communication, with the ability to make objective, evidence-based decisions in a fast-paced environment.
8. Mindsets:
   1. A team player who loves working collaboratively
   2. A sense of optimism, flexibility, and adaptability to any situation
   3. An ability to thrive in ambiguous situations due to your resilience and tenacity
   4. A growth mindset and a deep enthusiasm for learning, feedback, and continuous improvement
   5. A blend of passion, humility, patience, and a good sense of humor
   6. A tendency to roll up your sleeves to move projects forward
      

Why You Should Join Us

• On a roll: We are doubling year-over-year with new funding partnerships that are boosting expansion in multiple countries
• Great team: We are founded, managed, and backed by successful veterans of Stanford School of Medicine, Google, mPharma, and I&M Bank. We have technologists, doctors, and economists working side by side to solve difficult problems.
• Great funders: We’re supported by the Bill & Melinda Gates Foundation, USAID Development Innovation Ventures, CIFF, WHO FIND, and Pfizer to pay for healthcare on behalf of patients, with others to be announced soon.
• Huge market: We are disrupting a massive, growing $50+ billion market for healthcare payments for low-income patients, with a focus on paying for health outcomes to ensure patients get the best quality care.
• Great customers: We create financial incentives that ensure our healthcare providers deliver excellent care.
• Impact: We have cultivated a fun and exciting start-up culture that empowers our talented staff to make a huge impact.