Senior PHI Business Analyst – Memberships & Claims

Advance Delivery Consulting; Hornsby; On-site; AUD 90,000 - 130,000; Full time

Job summary

Advance Delivery Consulting is seeking a Senior Business Analyst with strong Australian Private Health Insurance (PHI) experience. You will work across membership management, product configuration, premiums, and claims, coordinating with stakeholders and delivery teams to translate business requirements into functional specifications.

You will collaborate with SMEs and IT to support PHI integrations with HICAPS, ECLIPSE, and Medicare, and contribute to testing and cutover activities.

Qualifications

• Senior BA with Australian PHI domain experience
• Strong understanding of PHI operations: membership, product, premiums, and claims
• Experience with PHI integrations such as HICAPS, ECLIPSE, and Medicare
• Solid documentation skills: BRDs, functional specs, process flows, user stories

Responsibilities

• Lead business analysis across PHI initiatives affecting membership management, product configuration, premium billing, and claims processing
• Capture and document requirements: member lifecycle events, product structures, premium and payment rules, and claims
• Translate requirements into clear functional specifications and user stories; collaborate with designers, developers, and testers
• Support SIT/ UAT by defining PHI test scenarios and validating outcomes against business rules
• Assist with implementation activities, change impacts, and post-release support

Skills

PHI domain knowledge

Stakeholder engagement

Requirements gathering

Functional specifications

Tools

JIRA

Confluence

Visio

Job description

Advance Delivery Consulting is seeking a Senior Business Analyst with strong Australian Private Health Insurance (PHI) experience. You will work across membership management, product configuration, premiums, and claims, coordinating with stakeholders and delivery teams to translate business requirements into functional specifications.

You will collaborate with SMEs and IT to support PHI integrations with HICAPS, ECLIPSE, and Medicare, and contribute to testing and cutover activities.