This paper addresses the Special Issue call for Australian examples of innovative management systems that enable the production of successful products by drawing on a single case study: medical device manufacturer Cochlear. Through qualitative case study methodology, we examine the human resource management practices that complemented the implementation of lean manufacturing principles. We argue that in their implementation, Cochlears management team enriched the traditional understanding of lean and its focus on waste reduction, low cost and quality assurance by adopting people management practices as an integrated component of the overall management capability which allowed their people to grow and develop. The combination of lean and HR practices transformed Cochlear to a high-performance work system and positively impacted production processes and output. By examining a medical device manufacturer, an under-researched sector, our paper expands existing literature on lean manufacturing and provides implications for practitioners.