Dr. James Mwangi Njoroge
Public Health Specialist
Nairobi
Summary
I am a health care access facilitator, with over 30 years experience in my career as a doctor and a public health specialist. I have developed a niche in health care financing (medical insurance schemes) in both the public and private sector. I have worked and undertaken Leadership roles (or co-innovate) to establish and strengthen health care delivery Logistics in suitable business-like contractual relationships. Usually this has entailed engagement of each of distinct stakeholders/ representatives serially or multi-laterally.
On a roundtable basis I have led co-opted teams from facilitator and client nominees to adapt, enhance modify or create quorums & streamline processes. I have also facilitated re-alignment(s) of mismatching objectives, processes or components in part of the Health Care Seeker-via-Health Cover Process via H.C.Beneficiary Cycle Continuum.
Overview
34
34
years of professional experience
13
13
years of post-secondary education
1
1
Certification
4
4
Languages
Work History
Medical Consultant
Nairobi West Hospital
Nairobi
2018.12 - Current
- Piloting model to expand DOSH's reach.
- Engage private companies intandem with the hospital's marketing department for business.
- Acquisition of Corporate Partners to take up the hospital's medical checkup packages.
- Consulted with healthcare professionals on business decisions.
Project Development Consultant
APN
Nairobi
2018.02 - 2018.12
- Built a Stakeholder network for the project.
- Designed and adapted Know Your Neighbors Health Awareness Program.
- Successfully implemented the first Medical Camp working with Donors& Local Partners.
- Recruited and oversaw personnel to achieve performance and quality targets.
Manager-Benefits and Product Development.
National Hospital Insurance Fund (NHIF)
Nairobi
2012.04 - 2017.09
- While based at the Head Office, I was in charge of monitoring, evaluating and revising the then sensitize 360 degrees Package.
- I conceptualized and guided the development of an application that was used to help analyze and revise M+E+R+S+N for enhanced healthcare outcome quality.
- Implemented a community health outreach program that was a success in over fourteen regions across the country
- Maintained energy and enthusiasm in fast-paced environment.
- Developed and implemented performance improvement strategies and plans to promote continuous improvement.
- Exceeded goals through effective task prioritization and great work ethic.
- Collaborated with team members to achieve target results.
- Led projects and analyzed data to identify opportunities for improvement.
Branch Manager
National Health Insurance Fund (NHIF)
Nairobi
2010.02 - 2012.03
- Led the Buruburu team to surpass its recruitment targets consistently for two years.
- Re-designed office administrative role for new membership/ benefits and tied into added hospital Role. Interrogation of linkages to roles can be a game changer
- Administration of covers focused on beneficiary outcome rather than on policy modulation and enhanced product development and entrenchment.
- Forecasted trends and recommended improvements based on financial risk analyses.
- Boosted sales and customer loyalty through incentive programs.
Standards and Quality Assurance Manager
National Health Insurance Fund ( NHIF)
Nairobi
2005.03 - 2010.01
- Realigned the funds care-lines versus hospital payments, beneficiaries against the monitoring and evaluation cycle.
- Rolled out key continuous alignment and service delivery strategies.
- Realigned the central role of product cycle management in partnership with key stakeholders that led to the successful outcome of efficient service delivery to all healthcare seekers.
- Evaluated interactions between associates and customers to assess personnel performance.
- Monitored staff organization and suggested improvements to daily functionality.
- Implemented new quality assurance and customer service standards.
- Estimated financial requirements of new projects.
Assistant Standards and Quality Assurance Manager
National Health Insurance Fund
Nairobi
2005.03 - 2006.03
- Actualized processing of member photocards and connectivity to ease free family access to services.
- Implemented Health Care on 24/7/365 basis at all accredited hospitals Established me as insurance guru
- Harmonized staff operations the hospital operations and member behavior
- Coordinated interdependence of players and same up with solutions by updating the respective ICT modules guided by user feed back.
Head of Health Department
Jamii Bora Trust, H.I
Nairobi
2001.03 - 2004.09
- I began the department and grew it from a two man department to a fifteen member department.
- Sought out, vetted and contracted member hospitals.
- Saved $10,000 per annum by implementing cost-saving initiatives that addressed long-standing problems.
- Converted the firm's medical scheme from pre-paid to debit financing-imbursement mode (Buffet re-imbursement Model).
- Grew the medical scheme's financial muscle through execution of a robust medical cover across the country.
- Work with all interets groups to destigmatise and grow membership enrollment through community outreahc programs.
- Education and member sensitization on the medical scheme and its benefits.
- Mentored facilitation
- Prepared variety of different written communications, reports and documents.
- Exceeded goals through effective task prioritization and great work ethic.
Director
Ngara Medical Services ltd
Nairobi
1994.03 - 2000.03
- Founded and managed an outpatient medical clinic offering end to end services to patients within nairobi and its environs.
- Spearheaded successful business development initiatives aligned with clinic's strategy and core competencies.
- Monitored and coordinated workflows to optimize resources.
- Established personnel performance metrics to encourage efforts toward common goals.
- Monitored sales forecasts and projected financial planning for the business to achieve revenue goals.
- Implemented process improvement to shape organizational culture, optimize procedures for higher efficiency and help company evolve and grow.
Medical Doctor
Malezi Project c/o Shelter Afrique Subsidiary
Nairobi
1993.03 - 1994.03
- Crafting and implementing primary health intervention-4( Slum and ASAL) Areas 1-Mathare,2-Soweto kayole 3-Mwingi(Wendo SHG)4-Kitui Kauwi-munganoSHG
- Interviewing community leaders and social workers and health centres to elicit and appreciate felt needs and co-design &implement interventions.
- Foster & train ToT Team for versatile follow up.
- Practiced proactive approach customized to prevent sickness and injuries in 4 low resource /income communities
- Achieved not only better health through community engagement but by modifying sponsor objectives & approaches. PHC approach is easily adaptable for products for setting: i)New Health Insurance Program ii)previously underserved /cohort 11 PP (private practice) neighborhood clinic Nairobi Suburbs
Chief Medical Doctor
Utalii College
Nairobi
1992.12 - 1993.02
- Act as index care giver to diagnose to treat /refer out student population (Ex Africa & S.EAsia.)
- Attend to staff and family and hotel guests medical needs
- Experienced and modified budgeting and business model mix to suit services for non homogeneous community
- Practical innovation in networking outreached services with different mix of in-house capability on limited budget
- Honed my predictive skills to be well prepared and able to provide responsive and excellent care
- Researched industry innovations and emerging treatments to improve care delivery.
- Implemented therapeutic regimens involving medications and other interventions to mitigate symptoms and prevent reoccurrence.
- Interviewed patients concerning physical complaints, discussed symptoms, asked questions and suggested treatment options.
Medical Assistant
Kenya Medical Research Institute (KEMRI)
Nairobi
1989.09 - 1991.10
- Student in inter-sectoral disciplines focusing on epidemiology
- Carried out field research on household amenity and status in two diverse communities around HIV and AIDS avoidance.
- Collaborated with medical and administrative personnel to maintain patient-focused, engaging and compassionate environment.
- Performed clerical duties, such as word processing, data entry, answering phones and filing.
- Assisted with routine checks and diagnostic testing by collecting and processing specimens.
Medical Officer, Assistant
Nyamira Sub-County Hospital
Nyanza
1988.03 - 1989.08
- I worked in Nyamira Sub district Hospital on rotation in four main Hospital Departments of patient elective and emergency caesarian section postmortem and certification
- Specialized in Public Health post graduate specialty (MPH) to master rural health care issues
- Worked on financing policies and their deployment to determine cohorts’ patterns and helped the team grasp different sets of Health priorities in “homogenous” communities
- Needs assessment within the public heath department.
Medical Intern
Kenyatta National Hospital
Nairobi
1987.02 - 1988.02
- Rotated in 4 disciplines in casualty at Kenyatta National Hospital Perform triage
- Developed expertise in techniques and challenges of outpatient care.
- Able to craft / edit a product of benefit packages fitting high demand setting & low demand setting.
- Internalized outpatient care provider crisis points and how to solve/ pre-empt
- Wrote detailed and professional progress notes for each patient, outlining notable events and examinations findings.
- Completed daily rounds to check on patients and identify any reasons for concern.
- Assisted patient medication administrations using various methods such as intravenous, intramuscular, oral, subcutaneous and pulmonary.
Medical Research Assistant
Kenya Medical Research Institute
Nairobi
1986.01 - 1987.01
- Apprenticed in pediatric care innovation and intervention.
- Research with interpretation and execution of study protocol in affordable Cost effective manner
- Exposure to and Innovation of intercurrent study design to solve healthcare delivery challenges.
- Medicine
- Carried out pediatric surgery
- Pediatrics confirmation of admission criteria, to diagnosis & treatment discharge(issue fit summary) follow up convalescence care
- Perform post mortems
- Identified issues, analyzed information and provided solutions to problems.
- Wrote autopsy reports and issued death certificates
- Able to Supervise & run stand alone (Level 4) hospital for inpatient care
Education
Master of Science - Public Health
Nairobi University- Medical School
Nairobi 1989.01 - 1993.08
Executive MBA - Strategic Management
Mount Kenya University
Nairobi 2017.01 - 2017.07
Bachelor of Medicine - Bachelor of Medicine And Bachelor of Surgery
The Nairobi University
Nairobi 1978.01 - 1985.12
Skills
Strategic planning and implementation
Affiliations
-Kenya Medical Association- Member
-Directorate of Occupational Safety and Health Standards (DOSH) -Designated Health Provider
Certification
Licensed Medical Practitioner - 1986 to date
Publications
• Nov 1992: Thesis: “Study of effect of Slum Housing on Family Health status”.
• 1993 Baseline Community Health Status Study - African Housing Fund for Malezi project.
• 2001 Baseline Community Health Status Survey-Jamii Bora Fund as Basis for hospital Insurance
• FY 2005/06- Research – Diagnostic Profile Study of NHIF Paid Claims (2005/2006)
(Maternity23%,Malaria 17% of Diagnosed Cases )
Accomplishments
• Sept 2015 to 2017: Participated and Modulated the successful transformation of NHIF Fraternity into a “Can do Attitude” work culture winning wide perception as being capable & acceptable in eyes of key stakeholders and Qualified to Drive Universal Health Cover.
• 2014 – 2015 Roll-out of new benefit Packages eg Foreign treatment, Dental, cancer, MRI & CT Scan, culminating in winning of court case and Gazettement of Enhanced NHIF Contributor Rates (Fed 2015)that doubled NHIF revenue base and set up Fund & country for Blue Ocean market growth that supported Expansion of accredited Health Care Providers,Clinical,Chemist & Ancilliary services & affordability via member capitation mode of Benefit & fund allocation.
• 2012-2014 Modulated Mainstreaming of first Mammoth(KSH.4Bpa) Managed Scheme i.e. CSDS med Scheme via M&E & Sensitization Exercise with formulation of Scheme Rules and Out patient cover Product pilot.
• 2010-2012-Innovated Informal sector methods, strategies and tools and piloted deeper integration of NHIF/Health Care Provider Partnerships as Manager in charge of Buruburu Branch
• 2008 – 2010 .Formulated Hospital Scorecard and Ranking Platform & Issued Quality Certificates
• 2007 – 2008: Refitted & rolled out Ministry of Health Hospital Quality Management System for adoption by hospitals & sustainable Quality Shift achieved(Industry wide).
• 2004 - 2006: Instigated and participated in successful transformation of NHIF into an agile and patient care financier of first resort by Replacing Manilla card with Photocard (family pocket friendly) and Issuance of contractual based packages limiting/eliminating hospital Co-payment demands; Formulated Intergrated Member Module update, re-vamping ICT-platform for low-cost Robust open-ended connectivity with Hospitals.
• Feb 2001 - Sept 2004: Co-Innovated & implemented affordable pre-payment-Mode based hospital Admission Treatment for access to un-subsidized comprehensive care for un-employed & un-employables via 5 member groups in Jamii Bora Trust Health & Life Insurance Program. Resulting in a Surplus yielding sustainable Cover eliminating Co-payments by beneficiaries.
• 1993 - 1994: Co-innovated and implemented a Primary Health Care and Early Childhood Education Program in Slums and ASAL (Kitui & Mwingi) via Malezi Bora Project in Shelter Afrique under African Housing Fund (AHF)Subsidiary.
Farming, Reading, Sports, Counselling
I am passionate about increasing and broadening my knowledge in various areas such as history, sports and farming. I am also a practicing farmer from a young age. I have always had an interest in farming and have undertaken many projects alone and in groups.
I like to work with young people and therefore I enrolled as a marriage counsellor in my church to impart my knowledge and help young couples learn from my experiences both good and bad.
Timeline
Medical Consultant
Nairobi West Hospital
2018.12 - Current
Project Development Consultant
APN
2018.02 - 2018.12
Executive MBA - Strategic Management
Mount Kenya University
2017.01 - 2017.07
Manager-Benefits and Product Development.
National Hospital Insurance Fund (NHIF)
2012.04 - 2017.09
Branch Manager
National Health Insurance Fund (NHIF)
2010.02 - 2012.03
Standards and Quality Assurance Manager
National Health Insurance Fund ( NHIF)
2005.03 - 2010.01
Assistant Standards and Quality Assurance Manager
National Health Insurance Fund
2005.03 - 2006.03
Head of Health Department
Jamii Bora Trust, H.I
2001.03 - 2004.09
Director
Ngara Medical Services ltd
1994.03 - 2000.03
Medical Doctor
Malezi Project c/o Shelter Afrique Subsidiary
1993.03 - 1994.03
Chief Medical Doctor
Utalii College
1992.12 - 1993.02
Medical Assistant
Kenya Medical Research Institute (KEMRI)
1989.09 - 1991.10
Master of Science - Public Health
Nairobi University- Medical School
1989.01 - 1993.08
Medical Officer, Assistant
Nyamira Sub-County Hospital
1988.03 - 1989.08
Medical Intern
Kenyatta National Hospital
1987.02 - 1988.02
Medical Research Assistant
Kenya Medical Research Institute
1986.01 - 1987.01
Bachelor of Medicine - Bachelor of Medicine And Bachelor of Surgery
The Nairobi University
1978.01 - 1985.12
Licensed Medical Practitioner - 1986 to date
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