Service Integrity Analyst

This role is responsible for safeguarding the business by identifying why failures occur investigating suspicious activity (including fraud) and managing the end to end remediation of sensitive incidents. The role will improve operational gaps in our service delivery. With a strong focus on internal systems reporting and investigations the role will proactively manage high impact operational cases and provide actionable operation insights.

The position will work closely with Risk Compliance Legal and frontline teams to help deliver a patient-first fraud framework and roadmap. This includes refining case management improving reporting accuracy assist in recommending practical controls and guiding change to reduce the businesss exposure to chargebacks high-risk orders and unauthorised transactions within a digital-first environment.

Key Responsibilities

Fraud & Suspicious Activity Analysis:

• Monitor and investigate suspicious cases specifically focusing on fraud detection and internal/external risk.
• Investigate control failures to determine how and why of process breakdowns and work with the Head of Contact Centre on remediation plans and preventative measures.
• Conduct deep dive reviews into anomalous data or behaviours that signal a breach in protocol.
• Map out Patient Journeys to identify pain points and control weaknesses.
• Document control issues and operational inconsistencies in fraud resolution.

Case Management:

• Manage a dedicated portfolio of sensitive cases.
• Handle inbound enquiries and conduct outbound calls to gather evidence on incidents and sensitive cases.
• Act as the primary point of contact for stakeholders involved in fraud/suspicious case investigations.

Insight Generation & Reporting:

• Translate investigative findings into actionable operational insights for leadership.
• Identify trends in control failures fraud patterns and complaints. Suggest process enhancements based on these insights.
• Manage PTX dashboard updates.
• Assist in developing metrics and reporting structures to monitor fraud management performance over time.

Stakeholder Collaboration & Change Management:

• Engage key stakeholders to align on improvement opportunities and secure endorsement for proposed changes.
• Assist in developing a change management and communication plan to support the adoption of new processes

Qualifications :

• Exceptional verbal skills for managing difficult or sensitive phone conversations
• Comfortable managing a high pressure portfolio involving sensitive or personal information
• Analytical and critical thinking with a pragmatic approach to problem-solving
• Investigation skills with the ability to identify patterns and root causes
• Sound knowledge of Montus operating systems and procedures
• Well developed written and verbal communication to clearly document processes and engage stakeholders effectively
• Experience working with external regulatory bodies (eg. ACCC)
• Knowledge of fraud detection frameworks and risk mitigation aligned with compliance and patient-first principles
• Experience in project management process mapping and operational analysis desirable
• Experience in healthcare telehealth or digital services environments desirable
• Familiarity with legal and regulatory requirements for fraud and compliance desirable

Additional Information :

Youll be joining a high-performing fast-paced team where your work drives meaningful impact in a leading tech company at the intersection of healthcare. We take pride in our driven and results-focused culture where ambitious individuals can push the boundaries of innovation and contribute to better outcomes for Australians.

Other benefits include:

• Gaining access to SAGED courses and more through the Greenhouse learning platform fostering continuous growth and development.
• Enjoying discounts with over 450 retailers through our Reward and Recognition platform.
• The freedom of a full-time work-from-home role.
• Access to co-working spaces in Sydney Melbourne Brisbane and select regional cities.
• Mental health support through our wellbeing platform Unmind.
• A private health insurance discount through Medibank.
• Up to 8 weeks of paid parental leave.
• Swag kits to celebrate key milestones in your journey with us.
• Enhance your home office with our work from home equipment allowance benefit.
• Being part of one of the fastest-growing industries in Australia improving the lives of hundreds of thousands of patients.

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We are committed to facilitating a barrier-free recruitment process and work environment. If you require any accommodations we welcome you to let us know so we can work with you to participate fully in our recruitment experience.

Remote Work :

Yes

Employment Type :

Full-time