Medical Advisor

General information

Name Medical Advisor Ref # 57666 Date Monday, February 23, 2026 Full / Part Time Full Time

Description & Requirements

12-Month Fixed Term | Melbourne Preferred | Drive Fair, Evidence-Based Healthcare Decisions

Bupa is seeking an accomplished Medical Advisor to join our Health Insurance team on a 12-month fixed-term contract, with strong potential for extension or permanency. This is a rare opportunity to apply your clinical expertise at scale, influence key healthcare decisions, and shape processes that impact over 4 million Australians — all within a supportive and flexible environment offering a highly competitive package.

The Opportunity

As a Medical Advisor at Bupa, you will act as a trusted Clinical Subject Matter Expert within our Health Insurance business. You will provide evidence-based medical advice to support fair, accurate, and timely claims decisions while contributing to broader clinical, contracting, and stakeholder initiatives.

You will:

• Provide strategic clinical advisory support to the Senior Manager and broader Health Insurance teams, including hospital contracting and health content initiatives
• Conduct rigorous, timely reviews of Hospital, Medical, and Ancillary claims, including Pre-Existing Condition (PEC) and Acute Care assessments, in strict alignment with fund rules, legislation, and Bupa policies
• Clearly articulate evidence-based clinical rationale to underpin eligibility decisions and support transparent communication with customers and healthcare providers
• Deliver independent second opinions and comprehensive reviews of disputed or escalated cases
• Partner with Claims Operations and Clinical Review teams to strengthen governance, optimise processes, and elevate service standards
• Maintain professional, empathetic, and authoritative engagement with members, hospital administrators, and treating practitioners
• Ensure full compliance with private health insurance legislation and internal governance frameworks through sound, defensible decision-making
• Provide credible clinical input to support government relations, media responses, and broader stakeholder communications as required

Ideal Candidate Background

The ideal candidate will have a strong clinical foundation, ideally with hospital-based experience (Medical Officer to Senior Resident level), complemented by broader experience as a General Practitioner, Specialist, or Senior Medical Officer. Experience in corporate, health insurance, or medico-legal advisory roles is highly valued. Previous exposure to hospital-based acute care, public health, or health policy environments is particularly desirable, as is experience providing second opinions, clinical governance advice, or contributing to claims and regulatory decision-making. This combination of hands-on patient care and strategic clinical advisory experience equips the candidate to make evidence-based, fair, and defensible decisions while influencing healthcare processes at a system level.

About You

• An experienced, fully registered AHPRA Medical Practitioner with at least three years of broad clinical experience. 
• Hold unrestricted registration and tertiary qualifications in Medicine, with recent experience in general practice, hospital-based acute care, public health, or corporate healthcare
• Possess deep clinical knowledge, capable of reviewing complex Hospital, Medical, and Ancillary claims, including PEC and Acute Care assessments
• Understand the Australian healthcare regulatory and funding environment, ensuring decisions comply with legislation, fund rules, and governance standards
• Communicate complex clinical reasoning clearly and professionally to both clinical and non-clinical stakeholders
• Build strong collaborative relationships across Claims Operations, Clinical Review, Hospital Administration, and external medical personnel
• Apply integrity, accountability, and fairness in all decision-making, keeping customer outcomes front of mind
• Work confidently both independently and in multidisciplinary teams, contributing to process improvements and service excellence
• Handle complex or disputed cases with resilience, empathy, and professionalism, providing second opinions and defensible outcomes
• Role model Bupa’s values of Brave, Caring, and Responsible in everyday decision-making and stakeholder engagement
• Maintain awareness of risk, compliance, and health and safety obligations, ensuring timely reporting and secure handling of information

Why Bupa

At Bupa, our purpose is helping people live longer, healthier, happier lives and making a better world. We offer a flexible, inclusive, and rewarding work environment where your clinical expertise contributes to meaningful healthcare outcomes at scale.

Benefits include:

• Fully subsidised Bupa health insurance
• Discounts on travel, home, dental, and optical services
• Exclusive partner discounts including Apple, Endota Spa, and New Balance
• An additional wellbeing day of leave each year
• A paid volunteer day to support causes you care about
• Hybrid working arrangements

We are committed to creating a safe, inclusive workplace that reflects the communities we serve. Applications from all backgrounds are encouraged. If you require adjustments during the recruitment process, please let us know when applying.

Apply now and help Bupa deliver fair, evidence-based healthcare decisions that make a real difference — today and into the future.

Location Melbourne Office (33X) Recruiter Rami Elghattis