Strategic Health Funding Professional

4 days ago

Melbourne, Victoria, Australia beBeeFunding Full time $221,345 - $245,919
Group Health Fund Manager

This role involves partnering with executive stakeholders and those influencing patient outcomes.

You will engage across a full spectrum to assess opportunities, provide analysis and guidance, support contract negotiation, operationalise and monitor performance and compliance for organisational objectives.

The Position
Plan, develop and manage to continually improve contract negotiation strategy, interpretation and performance; expanding knowledge coverage to hospital executive/caregivers and key stakeholders.

Analyse public care opportunities and needs to complement relationships and care delivery across hospitals.

Pro-actively build and maintain positive relationships with health funds, local, state or Commonwealth government funders and acting as a support on contract compliance matters including interpretation, claim dispute and audit processes.

Work collaboratively with an experienced team engaging in decision support strategies across funding functions including operationalising contract requirements and ensuring compliance processes are in place.

Develop and simplify contract rules, payment models and audit expectations with key areas of the organisation and funders.

Assist with the provision of advice &/or work on projects with hospitals, funding partners or other key stakeholders that require knowledge of legislative frameworks and public health regulations in the establishment of proposed new services/activities.

Further develop reporting of contract performance to ensure outcomes are beneficial to organisational objectives.

Review data and write reports, including the use of costing data for negotiation strategy where applicable.

Work with hospitals to increase accurate data capture and input in areas that drive compliance.

Assist research and provide information for use in patient care, clinical and hospital evaluations.

Facilitate evidence based best practice processes - contracting, compliance, coding, and key performance indicator development, ensuring identified issues have planned interventions.

Convey clearly the interpretation of health data analysis, be familiar with private hospital reimbursement models and benchmarking systems in the context of funding.

Apply your knowledge of funding models and processes and their importance to stakeholder relationships, including public sector and national bodies.

Ensure compliance with all applicable contracts, accreditation standards, and group policies.

Comply with relevant legislation and guidelines.

A driven individual who can work both collaboratively and autonomously to deliver outcomes. People at the core of everything you do committing to and supporting our Mission and Values.

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