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Program Overview

The Government of Rwanda (GoR) is committed to achieving Universal Health Coverage (UHC) by ensuring equitable access to quality health services for all citizens, as outlined in the Fifth Health Sector Strategic Plan (HSSP V). Achieving this ambition requires not only the expansion of services but also strengthening quality of care, accountability, and efficiency across the health system. Clinical audits are a critical component of this effort, providing an evidence-based mechanism to identify care gaps, strengthen adherence to standards, and ensure patient-centred, high-quality service delivery.

The Rwanda Social Security Board (RSSB), which manages key health insurance schemes including the Community-Based Health Insurance (CBHI) and RAMA, has established a medical audit division to improve quality and accountability in health service delivery. This division plays a central role in ensuring value for money, enhancing efficiency, and improving patient outcomes for the insured population.

Position Overview

To support this agenda, CHAI Rwanda seeks a Technical Advisor (TA) for Medical Audit to be seconded at RSSB. The TA will provide day-to-day technical and operational support to institutionalize the medical audit function, strengthen the division’s policy and operational framework, and build capacity within the team. This includes supporting the development of audit methodologies and tools, enhancing data-driven audit practices, mentoring staff, and establishing feedback and accountability mechanisms to drive continuous quality improvement.

This position will be instrumental in advancing RSSB’s mandate to ensure that health services financed through public insurance schemes are delivered efficiently, equitably, and with the highest quality standards—contributing to Rwanda’s broader UHC goals.

• Support institutionalization of the medical audit function by helping to develop the scope of the audit function, to develop and operationalize policies, guidelines, tools, and standard operating procedures (SOPs).
• Strengthen audit methodologies by designing and refining medical audit protocols, medical audit tools, case review processes, and reporting templates aligned with national and international standards.
• Build capacity of RSSB staff through on-the-job mentorship, structured training, and workshops to ensure sustainability of the medical audit function.
• Support the development of internal communication mechanism and effective collaboration with internal departments, including Compliance, Claims Management, Anti-Fraud, and Finance
• Support data-driven audits by improving the use of routine health and insurance data (HMIS, claims, patient records) for medical audit purposes.
• Ensure quality assurance and accountability by establishing mechanisms for feedback to providers, facilities, and decision-makers, and by tracking implementation of audit recommendations.
• Facilitate collaboration between RSSB, Ministry of Health, health facilities, professional bodies, and other stakeholders to ensure medical audit findings inform policy and practice.
• Promote learning and knowledge sharing by documenting best practices, lessons learned, and supporting peer-to-peer exchange within RSSB and across the health sector.
• Contribute to monitoring and evaluation (M&E) by developing indicators to measure the effectiveness of medical audits and reporting progress to RSSB and partners.
• Support integration with broader quality improvement initiatives to ensure clinical audit complements ongoing quality of care, health financing, and service delivery reforms.
• Other responsibilities as assigned by supervisor.

• Advanced degree in Medicine (MD) with a master’s degree in medicine, public health, health management or quality improvement.
• A minimum of 6 years of progressive professional experience in clinical practice and quality improvement, including at least 3–5 years specifically dedicated to medical audit, medical procedures review, or compliance required.
• Demonstrated experience in developing or applying clinical guidelines, treatment protocols, or quality improvement tools.
• Excellent skills in data analysis and health system evaluation.
• High levels of integrity, attention to detail, and regulatory compliance.
• Proven experience in advising government institutions, insurers, or large health programs on clinical quality, audit, or accountability mechanisms.
• Excellent working command of English language.

Required Competencies:

• Excellent skills in data analysis and health system evaluation.
• High levels of integrity, attention to detail, and regulatory compliance.
• Strong understanding of Rwanda’s health sector policies, treatment guidelines, and procurement systems.
• Prior experience working with health financing institutions, health insurance schemes, or medical audit divisions (e.g. private insurers, or donor-funded projects, medical regulatory body) would be an advantage.
• Experience in capacity building and mentorship, with a record of training and strengthening teams in medical audit or quality assurance.
• Experience in fraud detection and prevention in health financing or insurance settings.
• Strong knowledge of Rwanda’s health system, policies, and institutional frameworks.
• Ability to understand and speak Kinyarwanda will be an advantage.

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