Healthcare Funding Strategist

4 weeks ago

Melbourne, Victoria, Australia Bupaoptical Full time
About the Role

We are seeking a highly skilled and experienced professional to join our team as a Healthcare Funding Strategist. As a key member of our Claims Intelligence & Healthcare Funding team, you will play a pivotal role in the development and implementation of our Healthcare Funding Strategy.

Key Responsibilities
  • Conduct competitor and environmental scans to assess existing funding models in use.
  • Co-develop a new contemporary hospital funding model with selected hospital providers that meets the design principles and is implemented over time into all hospitals.
  • Ensure that Bupa's Hospital Funding Model is supported by recent cost weights and DRG versions.
  • Proactively seek feedback from Hospital Providers to maintain collaborative working relationships and to ensure the funding model remains contemporary and isn't leading to unintended consequences.
  • Develop health funding models that incentivise providers to deliver quality cost-efficient services.
  • Support the hospital contracting team when negotiations are underway.
  • Work closely with the GM APPO and HO Ancillary Partnerships to consider funding model options for Ancillary Providers.
  • Work closely with GM HMP and Medical Partnerships Manager to consider funding model options for Medical Providers.
  • Work closely with the Head of Data and Analytics and managers as we set up the Claims Intelligence and Healthcare Funding team as a Centre of Excellence (Co E).
What You'll Need
  • Extensive experience in public hospitals, private hospitals or private health insurance in Australia.
  • Extensive knowledge of health economics, clinical costing, funding models and health information management practices.
  • Significant knowledge of casemix funding principles and the ability to build financial, complex modelling and benchmarking models.
  • Significant experience in designing and developing reporting systems to support the gathering of insights on the performance of funding models.
  • Significant experience supporting the development of targeted health programs.
  • Strong understanding of the Australian healthcare system and its ongoing reform.
  • Demonstrated experience in leading and managing a team.
  • Prior experience working in a large, complex and matrix based reporting structure.
  • Excellent stakeholder management skills (internal/external).
  • Demonstrated ability to build strong business relationships at a senior level across the organisation.
  • Proven capacity to work well independently and to collaborate with others, as required.
  • Tertiary qualifications in a relevant health, analytics field or extensive relevant industry experience.
About Bupa

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. We operate 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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