Ancillary Integrity Consultant, Hcm

At Bupa, our purpose is helping people live longer, healthier, happier lives and making a better world.

Our Healthcare Management team have a part-time opportunity for a diligent
- **Ancillary Integrity Consultant.**:

- This is a permanent part-time position and can be based at one of our offices, Adelaide, Brisbane, Melbourne or Sydney offices when you are not working from home. (Bupa offers hybrid working and you can work from the office or at home)_

With your advanced analytical skills, you'll ensure any inaccurate payment of ancillary (extras) claims are prevented, detected, and recovered through the programs of works. This will encompass an understanding and proactive management of system rules, product, policies, and business rules.

You’ll also be responsible for conducting audits on members records and ancillary providers in accordance with fund and industry rules fairly and professionally.

**How will I help?**
- Key accountabilities include:

- Efficiently prioritise activities so the ancillary integrity function meets annual operating plan (financial) targets.
- Partner with the Claims Integrity Data science team to leverage data and process change to drive an increase in prevention of payment of incorrect claims.
- Analyse data to identify claim trends of claiming which can be used in the development of new business rules and collaborate with the data science team to further test and refine these rules.
- Conduct audits on ancillary (extras) claims to ensure they comply with fund, business and industry rules.
- Collaborate with Ancillary network team to manage planned audits on providers under the network to provide a good experience for our Members First Network, including providing feedback on any audit outcomes.
- Establish strong partnerships across the business to align the HCM approach with the enterprise and drive collaboration at every level.

**What do I need?**
- Diploma or certificate in investigation and/or fraud control is desirable
- Previous experience in conducting end to end investigations e.g misconduct, fraud
- Experience in operating within a high-pressured environment with competing priorities and multiple workstreams to achieve or exceed targets.
- Experience in working with data science/ analytics teams and/ or using advanced analytics concepts is highly desirable.
- Strong verbal and written communication to be able to persuade/ influence behaviour change both internally and externally.
- Engaging presentation with developed skills in analysing complex data, highlighting key focus points to be interpreted by all stakeholder levels.

**Benefits**:
We keep our people smiling by helping them improve their lives in and outside of the office. We’re a welcoming lot, no matter who you are or where you’ve come from. We welcome all talents and backgrounds and embrace our differences, so you can bring your true self to work. We support our people to be the best version of themselves, physically and mentally. With a healthy work/life balance, leadership support, reduced private health cover, study leave, volunteering options and a commitment to promoting from within.

Our employees can access wide range of benefits: from our own products (incl. health insurance discounts) to many other products and services via our partnerships program (like Apple, Samsung, JB Hi-Fi, plus gym and spa discounts to name a few). We reward our people and celebrate their success, provide initiatives that develop careers and look after our people’s health, wellbeing, and futures.

**About 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.