Fraud Intelligence & Risk Manager

Medibank; City of Melbourne; On-site; AUD 140,000 - 200,000; Full time

Job summary

Medibank is seeking a Fraud Intelligence & Risk Manager to lead the fraud intelligence and investigations function, driving detection, prevention and governance across members, providers and internal activity. You will lead a team and collaborate with Data & Analytics, Technology, Claims and Risk to deliver tangible business improvements.

You will shape the next phase of fraud maturity, translating complex intelligence into proactive controls and opportunities for stronger customer, financial

Qualifications

• Experience leading fraud investigations or financial crime teams.
• Strong people leadership and team development.
• Experience transforming capabilities or operating models.
• Ability to translate complex intelligence to actionable outcomes.

Responsibilities

• Lead fraud intelligence and investigations across detection, triage, and recovery.
• Mature intelligence-led approaches to patterns and threats.
• Translate insights into actionable prevention and controls.
• Partner with Data & Analytics and Technology to enhance detection.
• Develop and coach a high-performing team with rigorous standards.
• Report insights to senior leaders and governance forums.

Skills

Fraud investigations

Leadership

Stakeholder management

Analytics collaboration

Governance

Communication

Job description

It’s a strange thing to say, because us humans are capable of incredible things. And at Medibank, we know our greatest potential lies in the people who work with us.

We strive to make real, fundamental change, driven by a simple purpose: to create the best health and wellbeing for all of Australia.

The Opportunity – Fraud Intelligence & Risk Manager

Lead investigations today. Build fraud intelligence for tomorrow.

At Medibank, we're strengthening how we identify, understand and prevent fraud across members, healthcare providers and internal activity.

Reporting to the Head of Payment Integrity, this role leads our fraud intelligence and investigations function and plays a key role in shaping the next phase of fraud maturity across the business. The position is responsible for connecting intelligence, investigations, prevention, controls and risk governance to deliver better customer, financial and operational outcomes.

Leading a team of fraud investigators, you'll work closely with Data & Analytics, Technology, Claims, Risk and operational leaders to identify emerging threats, strengthen detection, improve prevention and ensure investigation outcomes drive meaningful business improvement.

What you’ll do

• Lead Medibank's fraud intelligence and investigations capability across detection, triage, investigation, recovery and referral activities.
• Mature an intelligence-led approach to identifying fraud patterns, typologies, networks and emerging threats.
• Identify fraud patterns, typologies, networks and emerging threats and translate insights into action.
• Strengthen the link between investigations, fraud intelligence, prevention and control improvement.
• Partner with Data & Analytics and Technology teams to enhance detection capability, analytics and responsible use of AI.
• Develop and coach a high-performing team while maintaining strong investigation standards, quality assurance and procedural fairness.
• Strengthen investigation standards, governance, reporting and quality assurance practices.
• Provide insights and recommendations to senior leaders and governance forums on fraud trends, risks and control effectiveness.
• Support risk management, control uplift and fraud governance activities across the Health Partnerships & Networks Hub.

Why this opportunity is different

This role sits at the intersection of fraud intelligence, investigations, prevention and risk.

You’ll join an established Payment Integrity function with experienced investigators, operational expertise and strong stakeholder relationships. The opportunity is to help shape how fraud intelligence continues to evolve, improve the use of data and insights, and strengthen how fraud learning is converted into earlier detection, prevention and measurable risk reduction.

Success will come from your ability to influence broadly, connect people and ideas, and turn complex intelligence into practical outcomes that make a genuine difference.

About you

You're an experienced fraud, intelligence, investigations or financial crime leader who combines strong analytical capability with commercial judgement.

You can demonstrate experience building, transforming, uplifting or maturing a capability, framework, operating model, intelligence process or control environment.

You’ll bring:

• Experience leading fraud investigations, fraud intelligence, financial crime or a comparable investigations function within a complex or regulated environment.
• Strong people leadership and team development capability.
• Demonstrated capability-building and transformation experience.
• Experience identifying fraud patterns, typologies, networks or systemic vulnerabilities and converting findings into prevention or control improvements.
• Strong stakeholder management and influencing skills.
• Experience partnering with data, analytics, technology or operational teams to improve detection and prevention outcomes.
• Sound understanding of governance, risk and control management.
• The ability to communicate complex information clearly and confidently with senior stakeholders.
• Experience in healthcare, insurance, provider or claims-related fraud will be highly regarded but is not essential. Equally valuable is a track record of building capability, improving outcomes and leading change in a complex environment.

Why Medibank?

This is a rare opportunity to influence the future direction of fraud intelligence and investigations within one of Australia's leading health organisations while working alongside experienced leaders, investigators and enterprise partners to create meaningful impact.

Imagine working with us

We understand that work means different things to everyone... We know happy, healthy people make great teams, and great teams put more heart into each customer and patient interaction. And that’s why we’re reinventing work.

Imagine a workplace that helps you and your family thrive. Where connection, personal development and health and wellbeing are front of mind. To learn more about our benefits go to https://careers.medibank.com.au/culture/rewards-benefits/

For you, work should help you Live Better. It should bring you fulfillment and joy. And with Medibank, it could.

Inclusion and Accessibility

We believe in everyone's potential and strive to make Medibank inclusive for all because different perspectives make us better. We encourage applications from everyone, including Aboriginal and Torres Strait Islander peoples, neurodivergent candidates, LGBTQIA+ community including transgender and gender diverse candidates and candidates with a disability.

Medibank proudly recognised as Best Enterprise Organisation, 2026 AFR BOSS Best Places to Work