Manager- Ancillary Integrity and Compensation
Brisbane, Australia
About the role:
Bupa is Australia’s largest health insurer and is committed to helping people live longer, healthier and happier lives in a better world. It supports the health and wellbeing needs of more than 4.7 million health insurance customers. Bupa has embarked on a global transition from Health Insurer to a Healthcaring company with the goal of becoming the world’s most customer centric organisation.
This position reports to the Head of Claims Integrity and is a key part of the Claims Integrity Leadership Team. Its primary responsibility is to oversee ancillary integrity and compensation functions, driving initiatives to identify, prevent, and recover financial losses from claims leakage in the ancillary and compensable space. The role utilizes strategic programs, process improvements, system enhancements, and advanced analytics to maximize operational effectiveness
The role demands a manager experienced in leading engaged teams to achieve commercial outcomes through strong stakeholder engagement, utilisation of advanced analytics and strong detection models. You will be required to work closely with key stakeholders and influence decisions across the business to manage rising cost growth and improve customer outcomes through identification and mitigation of claims leakage.
Key Responsibilities
- Lead the ancillary integrity and compensation functions to operate effectively and efficiently to meet annual operating plan (financial) targets.
- Establish a strong presence and relationships with providers, the legal community and other payers to drive high levels of detection and recovery of claims.
- Put measures in place to track actual financial performance against Annual Operating Plan, reporting any significant variances, trends and opportunities.
- Design, develop and maintain a rule register so all business integrity rules related to ancillary and potentially compensable claims are managed and captured in a central log, with strong governance oversight.
- Provide specialist input into the data science program of work and be the key point of contact with the Claims Integrity Data Science Team to leverage data and process change to drive better detection of compensable claims and ancillary claims leakage and efficient recoveries
- Embed quality assurance process to provide the business confidence in the team’s outputs, ensuring the team are adequately skilled to undertake their daily tasks, agreed processes are adhered to and financial reporting is accurately captured and reported.
- Develop a high performing team, empowering team members with a sense of accountability, responsibility and independence.
About You
- Degree qualified in Finance, Commerce, Law or an area of Healthcare (eg. Healthcare Management, Physiotherapy, Dentistry, etc) (desirable)
- Experience leading a mid-sized team, operating either in a Private Health Insurer, General Insurer, Law firm or other service-based industries.
- Demonstrated ability with engaging with both internal and external parties (i.e. solicitors) to influence decisions and encourage referrals.
- Experience building and developing a high performing team of diverse skill sets.
- Ability to balance the inherent tension between commercial imperatives and providing a leading customer experience for Bupa members.
- Track record of achieving outcomes and deadlines in a high-pressured environment.
- Ability to work collaboratively and effectively influence a diverse range of stakeholders including senior leaders, technical and functional specialists, operational and line managers.
Why Work with Bupa
When you become a part of the Bupa team, you're joining a company that values innovation, collaboration, and making a positive impact on people's lives. We offer a supportive and dynamic work environment that encourages your professional growth and development.
If you're ready to lead change, drive customer retention, and contribute to Bupa's success, we want to hear from you! Apply now and be a part of our journey towards delivering exceptional customer experiences.
Bupa Asia Pacific
Bupa is an international healthcare group which has been committed to a purpose of helping people live longer, healthier, happier lives and making a better world for more than 70 years.
Bupa Asia Pacific operates in Australia, New Zealand and Hong Kong, supporting about 6.5 million customers through a broad range of health and care services including health insurance, aged care, dental, medical, optical and hearing services. Employing more than 20,000 people in the region, we believe that we can make a real difference to the lives of customers through our values, purpose and the way that we deliver personalised care.
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