Head Of Healthcare Funding (Remote)

Reporting to the General Manager, Claims Intelligence & Healthcare Funding, this role is pivotal to the execution of the Healthcare Funding Strategy including but not limited to the development, introduction and ongoing management and oversight of provider funding models. 

The priority for this role is the development of a contemporary hospital funding model to replace the current model. This is a critical and highly strategic initiative for Bupa and will involve co-development with partner hospital providers to ensure all possibilities and voices are accounted for. This role will also provide funding model design and commercial support in the implementation of new innovative models of care and programs of work within HMP.

How will I help? 

Key accountabilities include: 

• Conduct competitor and environmental scans to assess existing funding models in use. This includes formative research and appraising the evidence base on the effectiveness (health and economic) of existing and/or new models of healthcare funding. 
• 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 
• Developing 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 (CoE)

What’s in it for me? 

As well as a competitive salary, a range of Bupa benefits and flexible working/ work from home arrangements, you’ll be challenged and encouraged to innovate. You will collaborate strongly with colleagues who are committed to delivering exceptional experiences. We trust, respect and consider everyone, knowing your difference will make the difference. 

What do I 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 

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.

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.