Hospital and Medical Integrity Manager

Why you'll love working at HBF

• Fully subsidised Gold Hospital Insurance for you and your family after 3 months
• Flexible working and work from home options
• 3 additional wellbeing days each year (on top of our standard 20 days annual and 10 days personal leave)
• 2 volunteering days per year
• 18 weeks parental leave
• Onsite Barista with subsidised coffee (Perth)
• Access to corporate discounts across a range of gyms, retail, restaurants and hotels

As the Hospital & Medical Integrity Manager, you will lead a highly specialised team responsible for protecting the integrity of our health claims and ensuring members' funds are used appropriately.

This is a role where you'll combine leadership, analysis, investigation and stakeholder engagement to help identify and prevent fraud, waste, abuse and error across hospital and medical claims.

You'll lead a team of specialists, work closely with providers and industry stakeholders, and influence improvements that strengthen HBF's payment integrity framework. It's a role with genuine impact, where your expertise will help safeguard value for our members while supporting fair and compliant outcomes.


What you'll do
No two days are the same in this role, you'll lead a specialist team, guide complex payment integrity work and play an important part in strengthening how HBF identifies and responds to fraud, waste, abuse and error across hospital and medical claims. You will also;

• Lead, coach and develop a high performing team responsible for hospital, medical and prostheses payment integrity activities
• Oversee post-payment reviews, recovery initiatives and complex investigations, working with providers and industry partners to resolve sensitive or disputed matters
• Use data, insights and industry knowledge to identify trends, risks and opportunities to improve policies, processes and contract outcomes

About you
You enjoy solving complex problems and getting to the heart of an issue. You're naturally curious, commercially minded and comfortable making decisions in situations where there can be competing priorities and differing opinions.

Most importantly, you're a people leader who knows how to bring a team together. You create clarity, build capability and support others to do their best work, while maintaining high standards and delivering meaningful outcomes.

You'll bring strong leadership experience and a solid understanding of healthcare, insurance, claims, audit, compliance or provider-related environments. You may have worked closely with hospital billing, clinical coding, medical billing or other healthcare processes, and you know how to navigate complex issues with care, confidence and sound judgement.

• Strong stakeholder engagement skills, with the ability to influence, communicate clearly and build trusted relationships at all levels
• Sound analytical capability, including the ability to interpret data, identify trends and use insights to support practical decision-making
• Ideally a Bachelor of Health Information Management or Diploma of Clinical Coding or significant experience within health insurance, hospital billing, medical administration, clinical coding or a related field.

Next Steps
To apply, complete your application attaching your CV that outlines your skills and experience in relation to this role.

At HBF, we believe in the unique potential of every individual. We're committed to building an inclusive workplace where diverse perspectives are valued and celebrated, because they make us stronger.

We encourage applications from all backgrounds, including Aboriginal and Torres Strait Islander peoples, people with disabilities and members of the LGBTQIA+ community.

We want you to Be You, Be Bold, and feel supported every step of the way. If you need any

adjustments during the recruitment process, please contact us at ••••@hbf.com.au so we can work together to accommodate your needs.

Discover how we're making a difference, explore our Community Initiatives at: Community Initiatives | HBF Health Insurance