On-base Credentialing Lead

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

At Bupa, purpose meets possible. Join us and help shape a future where healthcare is more connected, more personal and more human.

We’re a global healthcare leader trusted by millions and committed to helping people to live longer, healthier, happier lives and making a better world. Healthcare is changing, and so are we.

We’re investing in more clinics, better systems and smarter, more connected ways to help our customers. As we continue to expand our services and invest in innovation, you’ll help create a healthcare system that meets people where they are, responds to what they need and leaves them better than before.

Here, your work has purpose, your voice matters and your future is full of possibility.

Just imagine the impact you could make.

About the Role:

The ADF Health Services Contract (ADFHSC) provides integrated, end to end health support to 85,000 Australian Defence Force personnel across 59 facilities. Services span primary and occupational healthcare, dental, physiotherapy, mental health, pharmacy, health administration and rehabilitation, as well as pathology, imaging, radiology, allied health, specialist services, patient transport and other off base care delivered through Bupa systems.

The On Base Credentialing Lead provides expert guidance and oversight of ADFHSC credentialing and compliance for on-base services. The role ensures regulatory, contractual and organisational requirements are met, supports key stakeholders, drives process improvements and assurance activities, and ensures Health Practitioners are appropriately credentialed.

Responsibilities:

• Act as a subject matter expert regarding key clinical governance activities including credentialing for both 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

You will have:

• 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 ultimately 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

Why you’ll love it?

• A people-first culture that supports your health, happiness, and wellbeing.
• Career growth opportunities through ongoing learning and internal pathways.
• Exclusive benefits and discounts, including health insurance, tech, fitness, and lifestyle perks.
• Flexible working from home arrangements
• A workplace that recognises, rewards, and celebrates your success.

We support our people to be the healthiest and happiest versions of themselves.

Here at Bupa your wellbeing, identity, and personal story are respected and valued. We are committed to building diverse teams that are reflective of the communities we serve and fostering a fair and inclusive workplace free from discrimination, bullying and harassment. We encourage applicants from all backgrounds and experiences, including Aboriginal and Torres Strait Islander peoples, veterans, people with disabilities, and LGBTQIA+ applicants and are dedicated to removing barriers to participation.

We are dedicated to removing barriers to participation. If you need any reasonable adjustments during the recruitment process, or if you’d like to discuss how this role can be flexible for you, please let us know so we can support your participation on an equitable basis.

If this sounds exciting, we’d love to hear from you. Let’s shape the future of healthcare, together.