Remediation Operations Quality Specialist

3 months ago

Melbourne, Australia Bupa Full time

Two Permanent full-time opportunities
- Flexible working arrangement, based in our Melbourne or Adeliade CBD offices
- Highly rewarding role in a fantastic work culture

**The heart of the role**:
Working as a key member of the Remediation Operations Team, the Remediation Operations Quality Specialist would provide assurance to our Remediation Operations teams through regular quality and process assurance activities. They’ll collate insights through reporting and use them for risk management and continuous improvement

A Remediation Operations Quality Specialist also plays a crucial role in claims processes, identifying risk and impacts to business-driven changes and contribute to supporting our claims processing teams by maintaining Know-it content, providing advice and coaching support through feedback and assisting the team with new content

A critical role in ensuring the quality and effectiveness of remediation efforts within the health insurance industry. With focus on monitoring, improving, and maintaining high standards in the handling of claims and policies while ensuring compliance with relevant regulations

**Responsibilities**
- Execution of the Quality Assurance framework to support operational teams in delivering quality customer outcomes
- Delivery of training/skilling as required to meet the remediation pipeline
- Analysing data sets and providing valuable data driven insights to key stakeholders for informed decision-making and input into planning
- Complete accurate and timely reporting, analyse reports to identify insights and trends and implement actions where required
- Creation and maintenance of procedural and technical content for the benefit of the remediation operations teams
- Actively contributing as a process SME in business-driven and continuous improvement initiatives
- Initiate and contribute to identification of improvement opportunities for the end-to-end remediation process.
- Undertake all duties while maintaining compliance with internal policies, procedures, external laws, regulations, standards, and industry codes
- You may also carry out any other duties reasonably requested by Bupa from time to time.

**About You**:

- Generally, 3-5 years of experience in the health insurance industry is needed, with a focus on claims processing, policy management, or quality assurance
- Specific experience in handling or overseeing remediation processes and quality control within the health insurance domain is important
- Experience in quality assurance or quality control roles, particularly within health insurance or related fields, is essential
- Strong understanding of health insurance regulations, compliance requirements, and industry standards
- Proficiency in analysing data to identify trends, issues, and areas for improvement
- Ability to use data to make informed decisions and recommendations
- Familiarity with quality management software, claims management systems, and data analysis tools. Proficiency in using MS Office (Excel, Word, PowerPoint) for reporting and documentation
- Strong communication skills for preparing reports, delivering presentations, and collaborating with various stakeholders
- Ability to identify root causes of quality issues and develop effective remediation strategies. Strong problem-solving skills to address complex issues that arise during the quality assessment process

**We’ve got your back**

The special thing about Bupa is that care is at our core and will always be a part of how we operate. Extending that, we want our people to feel they are benefiting from Bupa’s purpose: so that everyone is supported to live the healthiest and happiest version of themselves. Simply put, this is what wellbeing means at Bupa.

Our global wellbeing program covers all aspects of our health - from mental and physical, to financial, social and environmental wellbeing. We are providing health benefits, information and support for everyone who works here, no matter their role.

**Our range of benefits include**:

- Fully subsidised health insurance products - How good is that
- Discounts on travel, car and home products, as well as discounts on Bupa services such as Dental and Optical, skin checks and vaccinations
- Discounted products and services via our extensive partner network, like Apple, Endota Spa, New Balance, Garmin, JB Hi Fi,
- An additional annual leave day for you to focus on your wellbeing
- An additional volunteer day each year for you to give back to your community

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