Clinical Reporting Analyst
The Clinical Reporting Analyst will synthesise, interrogate and interpret clinical business intelligence related to third party providers to identify trends in clinical behaviour and drive best practice. The role holder will work closely with the Clinical and Contracting teams to support the improvement of the contracted provider network, ultimately for the benefit of Bupa Global’s members.
The role holder should ensure through liaison with internal stakeholders that any aberrant provider behaviours are escalated and addressed.
Role responsibilities include but not limited to:
- Undertake reporting and thematic analysis of third party provider-related adverse clinical events to inform clinical and contracting discussions with senior management teams to drive quality improvement.
- Assist with conducting retrospective clinical audits of network providers, reviewing the invoices and related documents to assess any discrepancies in the billing of services.
- Work in partnership with the Clinical Governance Analyst to identify aberrant billing practices where providers are applying known techniques such as up-coding, un-bundling or use of unnecessary medical assistants, in order to extract additional revenue.
- Report recommendations to the Contracting team for improved network management and procurement practices.
- Assist with identifying and implementing clinical best practice into Bupa Global’s provider network through facilitating opportunities for shared learning and encouraging the utilisation and application of international standards and guidelines.
- Keep up to date on healthcare regulatory requirements per market and share this with relevant stakeholders.
- Ensure all audit outputs are executed efficiently and effectively, communicating these with key stakeholders across Bupa Global as appropriate.
- Link in with the Clinical Community across Bupa to learn and share best practice.
- Ensure third party provider compliance with contractual KPI’s and SLA’s (clinical quality and safety).
- Fulfil reporting duties related to internal assessment and evaluation of clinical risks pertaining to Bupa Global’s clinical operations and liaising with the Market Unit and Group Teams as and when necessary.
- Undertake administrative duties in relation to Bupa Global’s Clinical Committees as directed by the Clinical Governance Lead.
- Lead on projects as assigned by line manager.
- Demonstrate leadership and stakeholder engagement with all levels within Bupa Global and other business units.
- Essential experience – clinical background (and preferably clinical audit experience is ideal)
- Evidence of working to deadlines and achieving against set targets.
- Experience gained within an insurance or other corporate environment would be an advantage.
- Ability to understand and interpret data.
- Strong verbal and written English skills with ability to liaise at all levels.
- Second language and ability to represent Bupa externally to stakeholders would be beneficial.
- Flexibility – ability to adapt to changing work practices.
- Ability to use own initiative.
- Ability to work autonomously to organise own workload effectively and efficiently.
About The Company
Bupa’s purpose is longer, healthier, happier lives.
As a leading global health and care company, we offer health insurance, medical subscription and other health and care funding products; we run care homes, retirement and care villages, primary care, diagnostic and wellness centres, hospitals and dental clinics. We also provide workplace health services, home healthcare, health assessments and long-term condition management services. We have 32M customers globally. With no shareholders, we invest our profits to provide more and better healthcare and fulfil our purpose. We employ 86,000 people, principally in the UK, Australia, Spain, Poland, New Zealand and Chile, as well as Saudi Arabia, Hong Kong, India, and the USA.
We have grown significantly, particularly through 2013 to 2015, when we accelerated execution of our strategic vision. We are similar in revenue and profit to Marks & Spencer, and larger than Heinz in revenue. Because Bupa does not have shareholders it does not have a listing, but if it did it would be in the FTSE 100. Bupa is not a mutual or a charity but a company limited by guarantee that seeks to maximise its profits in order to fulfil its purpose. With customers in virtually every country in the world and 70% of its revenues now generated outside the UK, Bupa is a truly international organisation.
Bupa's Strategic Framework
Our strategy has three pillars: Customers, People, Performance. It puts our customers front and centre in the context of today’s digital age. As a service organisation, everything we do for our customers relies on our people and partners, so being a place where people love to work is critical to our success. This, combined with disciplined risk and capital management, is how we will deliver strong and sustainable performance. We are looking for individuals who share in our values and this strategy, and are capable of delivering outstanding results for the business.
Bupa Global provides products and services worldwide to people who want access to premium health and care at home or as they study, live, travel or work abroad. We provide international health insurance, travel insurance and medical assistance to individuals, small businesses and global corporate customers all around the world.
Bupa Global has over 1,800 employees and has offices in London and Brighton (UK), Miami (USA), Copenhagen (Denmark), Hong Kong (Greater China), and Dubai (UAE), as well as in Egypt, Mexico, the Dominican Republic, Bolivia, Panama, Guatemala and Ecuador. Bupa Global is currently organised around five regional hubs: Bupa Global Africa, India & Middle East; Bupa Global Greater China; Bupa Global Latin America; Bupa Global North America and Bupa Global Europe.