Claims SME

5 hours ago

Melbourne, Victoria, Australia Infosys Singapore & Australia Full time $90,000 - $120,000 per year

Infosys Consulting is the worldwide management and IT consultancy unit of the Infosys Group (NYSE: INFY), a global advisor to leading companies for strategy, process engineering and technology-enabled transformation programs. We partner with clients to design and implement customized solutions to address their complex business challenges, and to help them in a post-modern ERP world. By combining innovative and human-centric approaches with the latest technological advances, we enable organizations to reimagine their future and create sustainable and lasting business value. A pioneer in breaking down the barriers between strategy and execution, Infosys Consulting delivers superior business value to its clients by advising them on strategy and process optimisation as well as IT-enabled transformation.To find out how we go beyond the expected to deliver the exceptional, visit us at

We are seeking a highly experienced Claims Transformation Subject Matter Expert (SME) to support Bupa Australia in shaping and delivering its future-state claims operations. This role is pivotal in driving strategic transformation initiatives within the health insurance domain, with a strong focus on business operations, stakeholder engagement, and industry best practices.

Key Responsibilities:
  • Lead and support the design of the target state for claims operations, aligning with business goals and regulatory requirements.
  • Engage with stakeholders across all levels — from directors to business analysts — to ensure alignment and clarity on transformation objectives.
  • Contribute to the development and communication of executive-level documentation, including roadmaps, priorities, and target state designs.
  • Provide market-leading insights into industry best practices, emerging trends, and innovative approaches to claims transformation.
  • Shape requirements at epic and feature levels, ensuring business value and feasibility are well-articulated.
  • Offer strategic input on business value realization and the change effort required for successful implementation.
Required Skills & Experience:
  • Deep expertise in health insurance, with strong business acumen and operational understanding.
  • Proven experience in claims operations, particularly in designing and implementing future-state models.
  • Exceptional communication skills, with the ability to influence and engage executive and business-facing stakeholders.
  • Familiarity with Australian health insurance regulations (highly valued but not mandatory).
  • Exposure to Pega Smart Claims Engine or similar platforms (optional but advantageous).

We offer you great opportunities within a dynamically growing consulting organization. You will elaborate and deliver best practice solutions and will be able to further develop your skills. At Infosys Consulting you will discover a truly global culture that embraces diversity at all levels, working with highly dedicated and motivated colleagues, a cooperative work environment and interesting training opportunities.

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