Manager – Ancillary Integrity and Compensation

7 months ago


Melbourne, Australia Dental Corporation Full time
The key focus of this role is to lead the ancillary integrity and compensation functions to detect, prevent and recover financial losses as a result of claims leakage, through programs of work which are developed through the Claims Integrity roadmap by leveraging process, system and advanced analytics to operate more effectively. The role demands a leader experienced in leading teams to achieve commercial outcomes through strong stakeholder engagement, utilisation of advanced analytics and innovative techniques. You will be required to work closely with the Head of Claims Integrity and key stakeholders and influence decisions across the business to manage rising cost growth and improve customer outcomes through reduce claims leakage. How will I help? Lead the ancillary integrity and compensation functions to operate effectively and efficiently to meet annual operating plan (financial) targets. Establish a strong presence and relationships with providers, the legal community and other payers to drive high levels of detection and recovery of claims. Put measures in place to track actual financial performance against Annual Operating Plan, reporting any significant variances, trends and opportunities. Provide specialist input into the data science program of work and be the key point of contact with the Claims Integrity Data Science Team to leverage data and process change to drive better detection of compensable claims and ancillary claims leakage and efficient recoveries. Embed quality assurance process to provide the business confidence in the team’s outputs, ensuring the team are adequately skilled to undertake their daily tasks, agreed processes are adhered to and financial reporting is accurately captured and reported. Embed superior levels of professionalism when engaging with external parties such as solicitors and customers to uphold Bupa’s reputation through timely and exceptional customer service What’s in it for me? When you work at Bupa, we support your career and your lifestyle. We want to reward and celebrate our people. With a healthy work/life balance, leadership support, reduced private health cover, study leave and a commitment to promoting from within. Health and wellbeing is our top priority and it’s at the heart of everything we do. And we’ll make sure you feel it every day What do I need? Experience leading a mid-sized team, operating either in a Private Health Insurer, General Insurer, Law firm or other service-based industries. Demonstrated ability with engaging with both internal and external parties (i.e. solicitors) to influence decisions and encourage referrals Ability to balance the inherent tension between commercial imperatives and providing a leading customer experience Ability to work collaboratively and effectively influence a diverse range of stakeholders including senior leaders, technical and functional specialists, operational and line managers. Experience in successfully partnering across functions in the development and implementation of strategies to deliver commercial outcomes within complex, matrix organisations. Strong written and presentation skills and the ability to analyse complex data, pulling out key highlights which can be understood by senior management. What is it like to work there? 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

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