Senior Auditor, Claims

JobSpace; Christchurch; On-site; NZD 90,000 - 130,000; Full time

Job summary

Health New Zealand | Te Whatu Ora is seeking a Senior Auditor to join the Claims Audit Team, leading audits of contracted providers across New Zealand and assessing claiming, funding, and payment integrity.

This role requires strong pharmacy/healthcare credentials, the ability to drive continuous improvement, coach junior staff, and communicate complex findings clearly to stakeholders. Occasional travel up to three days per trip is required.

Qualifications

• Experience in healthcare funding, pharmacy services, or claims management.
• Strong analytical skills and ability to interpret complex information.
• Experience leading audits or projects through to completion.

Responsibilities

• Lead complex claims audit engagements from planning through reporting and follow-up.
• Audit healthcare claiming and funding processes across contracted providers.
• Evaluate compliance with contracts, regulations and funding requirements.
• Identify overpayment risks, control weaknesses and process improvements.
• Produce evidence-based audit reports and recommendations.
• Provide expert advice on claims assurance and risk management.
• Support development of claims audit methodologies and practices.
• Coach and mentor junior team members.

Skills

Auditing

Healthcare funding

Pharmacy

Data analytics

Stakeholder engagement

Team leadership

Education

Pharmacy Technician Practice

Healthcare Administration

Tools

Audit software

Data analytics tools

Job description

Jora New Zealand will close on 9th September 2026. Thank you for being with us, we are cheering you on as you continue your career journey.

Permanent, full-time position based in either Whanganui or Christchurch. Help protect the integrity of New Zealand's healthcare funding system.

About the Role

We're seeking an experienced Senior Auditor to join our Claims Audit Team, helping ensure healthcare funding, pharmaceutical claiming, and provider payments are accurate, compliant, and deliver value for New Zealanders.

This is an exciting opportunity for someone with a strong audit, pharmacy, healthcare funding, or claims assurance background who enjoys working in complex environments and driving continuous improvement.

As a Senior Auditor within the Claims Audit Team, you will lead audits of contracted health providers across New Zealand, assessing claiming practices, funding compliance, and payment integrity.

You will work with a wide range of stakeholders to identify risks, investigate anomalies, strengthen controls, and support improvements across the healthcare system.

Key responsibilities include:

• Leading complex claims audit engagements from planning through to reporting and follow-up
• Auditing healthcare claiming and funding processes across contracted providers
• Evaluating compliance with contracts, regulations, and funding requirements
• Identifying overpayment risks, control weaknesses, and process improvements
• Producing clear, evidence-based audit reports and recommendations
• Providing expert advice on claims assurance, compliance monitoring, and risk management
• Supporting ongoing development of claims audit methodologies and assurance practices
• Coaching and mentoring less experienced team members

Occasional travel throughout New Zealand is required, with travel of up to three days per trip.

About You

To succeed in this role, you will bring:

• Demonstrated ability to work independently, exercise sound judgement, adapt to changing priorities, and consistently deliver high-quality outcomes within demanding timeframes.
• A relevant tertiary qualification such as Pharmacy Technician Practice, Healthcare Administration, or a related field.
• At least four years' experience in healthcare funding, pharmacy services, claims management, medicines management, or a related area.
• Strong analytical skills and the ability to interpret complex information and identify risks.
• Experience leading complex projects or audit engagements through to completion.
• Excellent written and verbal communication skills.
• Strong relationship management and stakeholder engagement skills.
• Understanding of Te Tiriti o Waitangi and its application in practice.

Essential Claims Audit Experience

• Current or previous registration as a Pharmacy Technician, or
• Significant experience working in a New Zealand community or hospital pharmacy environment
• Knowledge of pharmacy dispensing processes, pharmaceutical claiming systems, Health New Zealand funding arrangements, and relevant regulatory requirements
• Experience in provider audit, healthcare funding assurance, claims review, or compliance monitoring
• Knowledge of pharmaceutical funding and reimbursement processes
• Understanding of the Pharmaceutical Schedule and pharmacy compliance requirements
• Experience within Health New Zealand, primary care, pharmacy, or other publicly funded healthcare organisations
• Experience using data analytics and audit technologies

Working for Health New Zealand

Health New Zealand | Te Whatu Ora is dedicated to ensuring excellent healthcare for the people of New Zealand. We embrace a workforce that is diverse and inclusive so that we are better positioned to understand and service our community. We welcome applications from our diverse Māori, Pacific, disabled, and rainbow communities.