Monitoring, Audit and Fraud Officer

Aha Corporation; Melbourne; Hybrid; AUD 85,000 - 110,000; Full time

Benefits offered by this job

Hybrid work (up to 4 days)

Training and development

Inclusive team culture

Job summary

AHA is Australia's leading health and human services consultancy, seeking a Monitoring, Audit and Fraud Officer to join the Pharmacy Programs Administrator (PPA) project in Melbourne. The role focuses on monitoring, compliance and fraud detection across government-funded pharmacy programs, ensuring eligible payments with proper evidentiary documentation.

You will analyse claims data, review provider eligibility, draft compliance communications, and support reporting cycles.

Qualifications

• 3+ years of experience in a compliance or project administration role.
• Excellent attention to detail and investigative skills.
• Exceptional communication skills, both written and verbal.
• Intermediate to advanced Microsoft Office suite – Word, Excel, Outlook.

Responsibilities

• Assess and analyse claims data against supporting evidence.
• Review eligibility of Service Providers and claims in line with program rules.
• Liaise with Service Providers and Department representatives regarding compliance matters.
• Draft a range of compliance communications, including bulletins and letters highlighting common issues and improvement opportunities.
• Contribute to weekly, monthly and quarterly reports for the Department.
• Collaborate with the PPA Support Centre and PPA Program Leads to address non-compliance issues.
• Record, assess and investigate compliance tip-offs.
• Maintain accurate records of compliance activities and investigations.

Skills

Compliance

Data analysis

Audit

Communication

Project coordination

Education

Tertiary qualification in business/health/pharmacy

Tools

Microsoft Office

Job description

AHAis Australia's largest specialist health and human services consultancy.Now in our 35th year, we partner with federal, state and territory governments to improve health and social outcomes for Australians by delivering evaluations, reviews and program administration engagements of major national importance.

AHA’s story is all about its people. We pride ourselves on our supportive and inclusive culture, and on the vision, creativity, and drive of our staff. Our high-performing team of passionate and talented individuals works collaboratively to deliver great outcomes for our clients.

About the role

We’re seeking a Monitoring, Audit and Fraud Officer to join our busy monitoring and compliance team within the Pharmacy Programs Administrator (PPA) project. The PPA is responsible for administering 27 government funded pharmacy programs on behalf of the Australian Government Department of Health, Disability and Ageing. These programs provide government funding to pharmacies, pharmacists and other entities to deliver a range of important programs and services.

As part of this engagement, the PPA receives and processes more than 4.5 million claims annually and makes payments exceeding $400 million each year via a purpose-built claims and payment IT portal. One of the PPA’s key contractual requirements is to deliver a comprehensive monitoring and compliance function to ensure claims meet relevant program rules and to identify, detect and correct compliance issues including potential fraud.

In this role, you will report to the team Manager and be part of a team responsible for ensuring that those receiving payments under these programs are eligible, following all required rules and have all necessary evidentiary documentation.

As part of the team, you’ll:

• Assess and analyse claims data against supporting evidence.
• Review eligibility of Service Providers and claims in line with program rules.
• Liaise with Service Providers and Department representatives regarding compliance matters.
• Draft a range of compliance communications, including bulletins and letters highlighting common issues and improvement opportunities.
• Contribute to weekly, monthly and quarterly reports for the Department.
• Collaborate with the PPA Support Centre and PPA Program Leads to address non-compliance issues.
• Record, assess and investigate compliance tip-offs.
• Maintain accurate records of compliance activities and investigations.

On offer:

• An attractive salary aligned with your skills and experience.
• Flexible working arrangements, with a mix of work from home (up to 4 days per week depending on your preference) and office based (Melbourne CBD) work.
• Provision of technical equipment with access to leading customer support software.
• Ongoing training and support.
• A supportive and collegiate team environment.

About you

You have:

• 3+ years of experience in a compliance or project administration role.
• Excellent attention to detail and investigative skills.
• Exceptional communication skills, both written and verbal.
• Intermediate to advanced Microsoft Office suite skills – Word, Excel, Outlook.
• Proven organisational skills with the ability to prioritise workload and schedule tasks.
• An ability to work both autonomously and in a team environment.
• Previous experience working in a pharmacy environment.
• A tertiary qualification in business, health and/or pharmacy.

Note: applications that do not include a tailored cover letter will not be considered.

All questions can be directed to ***********@aha.com.au

Due to the nature of the work, applicants must have Australian citizenship.

Additional information about the Pharmacy Programs Administrator (PPA) can be found at www.ppaonline.com.au

Further information about AHA is available at our website: www.aha.com.au

AHA is an Equal Opportunity Employer who provides an inclusive work environment and embraces the diverse talent of its people. We support flexible and accessible working arrangements for all. This includes people with a disability, Aboriginal and Torres Strait Islanders, culturally, religiously, and linguistically diverse people, young people, older people, and people who identify as gay, lesbian, bisexual, transgender, intersex, or queer. All are encouraged to apply.