Organisational Structure
The Executive Management Team consists of the Chief Executive Officer, Deputy Chief Executive Officer - Finance, Governance, Customer Service Strategy & Development and Deputy Chief Executive Officer - Government Relations and Program Integrity.
Medicare Australia is a Statutory Agency within the Australian Portfolio of Finance within the Department of Human Services.
Medicare Australia's structure supports our strategic direction of improving Australia's health through payments and information. There is a National Office in Canberra and offices in each State capital. There are nine payment processing centres and a network of 238 community-based Medicare offices.
Executive Management
Chief Executive Officer
Medicare Australia's Chief Executive Officer is Catherine Argall.
Deputy Chief Executive Officer
The Deputy Chief Executive Officer Finance, Governance, Customer Service Strategy & Development is Rona Mellor.
The Deputy Chief Executive Officer Government Relations & Program Integrity is Philippa Godwin.
National Office Management
The main functions located in Medicare Australia's National Office in Canberra include:
The Customer Services Division (CSD)
- supports the core business of making payments and collecting and providing information;
- services and products delivered by CSD support the customer service officer to do their job and meet or exceed customer expectation;
- CSD provides mainframe and other business system support, training and information tools;
- the State infrastructure that is part of, and is supported by the Division, creates the operational structure and environment through which service delivery happens.
Information Technology Services Division (ITSD)
- Provides strategic IT services to Medicare Australia and the Health Sector;
- Ensure infrastructure services support both Medicare Australia's business requirements and IT Architecture;
- Supports the Medicare Australia core business by providing effective Quality Assurance services;
- Research and assess IT related technologies, tools and processes that will increase Medicare Australia 's capability and/or reduce its operating costs.
Program Review Division (PRD)
Core business responsibilities of the Program Review Division are:
- to ensure that program payments are made to the right recipients, at the appropriate times and in correct amounts:
- This is supplemented by program of post-payment compliance activity undertaken by the Program Review Division (PRD) to enhance compliance by health professionals, pharmacists and consumers who utilise health programs.
- assess risk to the programs Medicare Australia administers:
- Techniques such as environmental scanning and data analysis are used to identify those areas within programs at higher risk of non compliance.
- A number of strategies are then implemented to enhance compliance within these risk areas.
eBusiness & Development Division (eB&DD)
eB&D ensures that Medicare Australia is strategically positioned within the health sector to improve health outcomes. The Division also identifies, develops and integrates new business opportunities both nationally and internationally. Core business activities of eB&D include:
- Online Claiming which enables healthcare professionals to conduct billing, claiming and information processes over the internet. This includes claims related to Medicare, Department of Veterans' Affairs and in-hospital care. Healthcare professionals can also submit information electronically to the Australian Childhood Immunisation Register.
- Development of eHealth solutions , including the introduction of consumer online services, as well as the registration and rollout of Medicare smartcards for HealthConnect.
- Management of a Health Public Key Infrastructure, by enabling health professionals and organisations to claim electronically and share health information securely through online identification and authentication.
- Modernising Aged Care Payments, by enabling better integration and coordination of payments for health and aged care programs. Aged care providers will be able to exchange payment related information with Medicare Australia across the Internet, resulting in efficiencies for the sector and government.
- Supporting the development and maintenance of all Medicare Australia web content.
Support Functions (Finance, Property, Physical Security and Human Resource Management)
- In partnership with Medicare Australia's customer agencies (eg. Department of Health and Ageing, Veterans' Affairs and the Department of Family and Community Services), establish the policy, business rules and resource requirement for the government programs administered by Medicare Australia (eg. Medicare, Pharmaceutical Benefits Scheme, Medical Indemnity etc).
- Ensure that Medicare Australia's programs are coordinated with the Department of Human Services.
- Work with Divisions in Medicare Australia to ensure that government programs are administered efficiently, effectively and according to government policy.
- Work with customer agencies to develop and cost New Policy Proposals.
- Provide timely OH & S services including advice, workplace assessments, seminars and updates.
- Provide Equity and Diversity advice and maintain policies in accordance with current guidelines and legislations.
- Provision of Learning and Development policies, advice and training.
- Establish, monitor and maintain the Medicare Australia Performance Support Program.
- Support the Chief Executive to discharge financial management responsibilities in accordance with relevant legislation and high quality financial performance;
- Assist with and influence the development of future strategic directions of Medicare Australia;
- Meet the needs of the Minister, Agency Executives, Staff and Suppliers on financial management issues;
- Control the integration of budgeting and accounting information to ensure consistency of approach across Medicare Australia;
- Manage the national property services function
- Manage the office services and physical security functions
- Manage corporate business continuity functions
- Administer national purchasing activities
- Provide detailed corporate support to Medicare Australia, including;
- Negotiation and administration of Certified Agreements and AWA's,
- Establishment of appropriate Work Level Standards,
- Production and delivery of new starters guides and induction processes,
- Conduct Staff Surveys,
- Develop and manage HR Reporting processes,
- Provide detailed Workforce Planning services across the organisation.
State Management
State managers are responsible for Medicare offices and payment processing centres in each State. They also liaise with the Department of Veterans' Affairs
in regards to the processing of Repatriation Pharmaceutical Benefits Scheme claims.
All Medicare offices provide Medicare services including cash, cheque and electronic funds transfer (EFT) payments and process Medicare enrolments and registrations as well as Pharmaceutical Benefits Scheme refunds. Family Assistance Office services are available in all Medicare offices, and customers may also visit a Medicare office to lodge participating health fund claims under Medicare two-way arrangements or lodge claims for the Federal Government 30% Rebate on private health insurance.
The locations for Medicare offices are determined by an analysis of community demographics and billing patterns.
| State | City | Urban | Rural | Total |
|---|---|---|---|---|
| Australian Capital Territory | 1 | 4 | 0 | 5 |
| New South Wales | 4 | 29 | 55 | 88 |
| Victoria | 3 | 32 | 21 | 56 |
| Queensland | 1 | 21 | 26 | 48 |
| South Australia | 1 | 5 | 7 | 13 |
| Western Australia | 1 | 10 | 6 | 17 |
| Tasmania | 1 | 4 | 2 | 7 |
| Northern Territory | 1 | 2 | 1 | 4 |
| Total | 13 | 104 | 117 | 238 |
Organisational chart structure
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Last updated: 29 May, 2008