Credentialing Lead, Clinical Governance & Compliance (Remote)

Bupa Australia; Sydney; Hybrid; AUD 120,000 - 170,000; Full time

Benefits offered by this job

Health insurance

Flexible working from home

Tech and lifestyle perks

Job summary

Bupa Australia is seeking an On Base Credentialing Lead to oversee credentialing and compliance for on-base healthcare services. You will guide clinical governance practices, manage credentialing checks, waivers and endorsements, and collaborate with delivery teams and external stakeholders.

The role focuses on regulatory and contractual compliance, process improvements, and building a high-quality credentialing culture across Bupa systems.

Qualifications

• Health Professional / Allied Health practitioner with experience in Clinical Governance, Quality and Risk management experience
• Post Graduate qualifications or working towards i.e., Quality Management, Health Administration, Clinical Governance or similar would be highly desirable
• Demonstrated ability to build and refine service delivery and clinical governance processes
• Proven ability to develop and implement frameworks, drive outcomes and deliver programs of work
• Strong conceptual, analytical, problem solving and strategic planning / thinking ability
• Excellent communication and stakeholder management skills
• Experience implementing organisational wide quality improvement initiatives and influencing teams in building a high-quality improvement culture

Responsibilities

• Act as a subject matter expert regarding key clinical governance activities including credentialing for onboarding and ongoing requirements, escalation of clinical matters and support to Service Delivery teams.
• Providing clinical support to the Service Delivery, Regional Partnership Managers, Subcontactor teams including managing clinical escalation and risk management.
• Clinical input into all credentialing activities for on-base workforce including daily credential checks and input into waivers/exemptions/endorsements and liaison with relevant external stakeholders.
• Provide clinical input into operational and process designs
• Escalate emerging risks and identify system-level themes aligned with continuous improvement opportunities
• Act as a proactive process change leader to ensure the integrity of all credentialing systems is maintained
• Establish good working relationships with all business services and other central functions to ensure clinical credentialing and risk awareness and developments are communicated
• Ensure business alignment and adherence to industry standards and requirements within the Bupa clinical governance, risk management and compliance framework particularly relating to clinical credentialing

Skills

Clinical governance

Quality and risk management

Process improvement

Framework development

Strategic thinking

Analytical skills

Problem solving

Communication

Stakeholder management

Quality improvement culture

Education

Postgraduate qualifications in Quality Management

Postgraduate qualifications in Health Administration

Clinical Governance postgraduate study

Job description

Bupa Australia is seeking an On Base Credentialing Lead to oversee credentialing and compliance for on-base healthcare services. You will guide clinical governance practices, manage credentialing checks, waivers and endorsements, and collaborate with delivery teams and external stakeholders.

The role focuses on regulatory and contractual compliance, process improvements, and building a high-quality credentialing culture across Bupa systems.