Manager - Healthcare Services

Job Title: Manager – Healthcare Services

To resolve internal escalations of non-approved pre-authorization cases on time and restore member confidence through clear communication and coordinated clinical review.

• Handle internal escalations of non-approved pre-authorization cases.
• Coordinate clinical review of escalated cases.
• Coordinate with Medical, Operations and Customer Care to resolve cases on time.
• Track open escalations to control the case backlog.
• Conduct recovery reviews for predefined eligible cases.
• Contact members to understand and address their concerns.
• Communicate case outcomes to members clearly.
• Follow up after adverse service experiences to restore member confidence.
• Analyse escalations, complaints and rework drivers to identify root causes.
• Identify process gaps and improvement opportunities.
• Recommend corrective and preventive actions for approval.
• Coordinate agreed actions with cross-functional stakeholders.

Bachelor’s degree in Medicine and Surgery.

• Healthcare insurance operations and pre-authorization processes
• Medical policy and benefit interpretation
• Case management and service recovery methodologies
• Customer experience and complaint management
• Healthcare analytics and performance reporting
• Quality assurance and root cause analysis
• Process improvement and operational excellence
• Data visualization and dashboard interpretation
• Risk assessment and escalation management
• Communication, stakeholder management and negotiation skills

Full Time

Any Nationality

Bupa is an international healthcare organisation offering health insurance and medical services to customers around the world. Its operations span hospitals, clinics, dental centres and aged care, alongside workplace health and digital consultation services. Having no shareholders, Bupa reinvests its profits back into patient care and the wider business.

Healthcare

18 December 2026