BE AT THE HEART OF IT WITH BUPA

Bupa is Australia’s largest health insurer and is committed to helping people live longer, healthier and happier lives in a better world. It supports the health and wellbeing needs of more than 4.7 million health insurance customers. Bupa has embarked on a global transition from Health Insurer to a Healthcaring company with the goal of becoming the world’s most customer centric organisation.

This is a full-time, permanent position based in Melbourne, Sydney, Brisbane, or Adelaide.
This position is a hybrid role - while primarily work-from-home, you may be required to attend the CBD office occasionally to collaborate with the broader team.

This role uniquely blends the clinical expertise of pharmacy with the strategic, corporate side of healthcare. In this position, you will:

• Manage and maintain the Drug Database and related collateral, ensuring medications listed for reimbursement align with Pharmacy and Product Policies.
• Provide expert pharmaceutical advice to product teams, ensuring compliance with private health insurance legislation and regulations.
• Ensure Bupa adheres to PBS, TGA, and other regulatory standards relating to drug coverage and reimbursement.
• Review and assess high-cost drug claims for alignment with hospital agreements and health insurance policies.
• Analyse pharmaceutical data to identify trends, risks, or potential claims leakage.
• Advise the hospital contracting team on high-cost drug clauses during contract negotiations, offering insights into pricing, reimbursement models, and regulatory requirements.