Training on Health Insurance Management & Policy Design
Training on health insurance management and policy design covering claims, risk management, and compliance.
Next intake
20 Jul 2026 · Nakuru
Duration
5 days
Live instruction
Delivery
Physical + Virtual
Cohort based
Level
Intermediate
Working professionals
Certification
NITA reimbursable
For Kenyan cohorts
Language
English
All materials
About this programme
Effective health insurance systems are essential for improving healthcare access, managing costs, and ensuring financial protection for individuals and organizations. Designing sustainable health insurance policies requires a balance between affordability, coverage, risk management, and regulatory compliance.
This course provides a comprehensive understanding of health insurance management and policy design. Participants will learn how to develop health insurance products, manage claims, control costs, and design policies that meet the needs of diverse populations while ensuring sustainability and compliance.
Duration
5 Days
Who Should Attend
- Health insurance professionals and managers
- Policy makers and regulators
- Healthcare administrators
- HR and benefits managers
- Finance and risk management professionals
What you'll walk away with
By the end of the course, participants will be able to:
- Understand health insurance systems and policy frameworks
- Design and evaluate health insurance products
- Manage claims and provider networks effectively
- Control healthcare costs and risks
- Ensure compliance with regulatory requirements
What we cover, module by module
Module 1: Introduction to Health Insurance Systems
- Overview of health insurance models
- Public vs private health insurance
- Key stakeholders in health insurance
- Policy frameworks and regulations
- Case Study: Health insurance system challenges
- Practical: Mapping a health insurance system
Module 2: Health Insurance Product & Policy Design
- Designing health insurance products
- Coverage, benefits, and exclusions
- Premium setting and pricing models
- Customer-centric policy design
- Workshop: Developing a health insurance policy
- Case Study: Policy design comparison
Module 3: Claims Management & Provider Networks
- Claims processing and administration
- Fraud detection and prevention
- Managing healthcare providers and networks
- Service quality and cost control
- Practical: Claims processing simulation
- Case Study: Claims management challenges
Module 4: Risk Management & Cost Control
- Identifying health insurance risks
- Risk pooling and underwriting
- Cost containment strategies
- Managing adverse selection and moral hazard
- Workshop: Risk management plan
- Case Study: Cost control strategies
Module 5: Regulation, Compliance & Future Trends
- Regulatory requirements and compliance
- Policy monitoring and evaluation
- Digital health insurance solutions
- Emerging trends in health insurance
- Capstone Exercise: Health insurance policy proposal
Where the change lands
Individual Impact
- Strong understanding of health insurance systems
- Improved skills in policy design and claims management
- Enhanced ability to manage risks and costs
- Increased confidence in decision-making
Organizational Impact
- Improved policy design and service delivery
- Better cost control and risk management
- Enhanced compliance and governance
- Increased customer satisfaction and coverage
Dates and locations
Upcoming intakes
Every intake is limited to a small cohort. Booking closes when a date fills or three weeks before the start, whichever comes first.
| City | Starts | Ends | Delivery | Book |
|---|---|---|---|---|
NakuruNext | 20 Jul 2026 | 24 Jul 2026 | In-Person | Book |
Kigali | 20 Jul 2026 | 24 Jul 2026 | In-Person | Book |
Accra | 20 Jul 2026 | 24 Jul 2026 | In-Person | Book |
Kisumu | 27 Jul 2026 | 31 Jul 2026 | In-Person | Book |
Johannesburg | 27 Jul 2026 | 31 Jul 2026 | In-Person | Book |
Dakar | 27 Jul 2026 | 31 Jul 2026 | In-Person | Book |
- NakuruNext
20 Jul → 24 Jul·In-Person
Book this intake - Kigali
20 Jul → 24 Jul·In-Person
Book this intake - Accra
20 Jul → 24 Jul·In-Person
Book this intake - Kisumu
27 Jul → 31 Jul·In-Person
Book this intake - Johannesburg
27 Jul → 31 Jul·In-Person
Book this intake - Dakar
27 Jul → 31 Jul·In-Person
Book this intake
Common questions.
Still not sure? Send us a note and a facilitator will get back to you within a business day.
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Course finder
Find the right course for you
Prefer to talk it through? Send us an enquiry and a facilitator will scope a fit within a business day.
For corporate teams
Training 10+ professionals?
We deliver Training on Health Insurance Management & Policy Design in-house at your offices, at a venue we arrange, or fully virtual. Customise the curriculum against your KPIs, and get a bespoke price for the cohort size you need.