Senior Claims Optimisation Consultant (Remote)

Senior Claims Optimisation Consultant | MetLife Insurance | Australia

 Summary of Responsibilities: 

 To drive operational efficiencies by managing claims capabilities within the MetLife Claims Customer Experience team and support claims optimisation through continuous improvement initiatives aligning to MetLife’s strategy.  

Principle Responsibilities: 

•  Proactively manage claims capability end to end; including the coaching and mentoring of claim associates through the Claim Accreditation Programme and Onboarding 
• Review complex claims as the business requires to recommend and implement claim resolution aligned to IDII and duration management principles; including coaching claim associates, adhering to claims philosophies, SLAs and other core claims metrics 
• Manage and assess MetLife staff claims 
• Adhere to all claim risk management frameworks and requirements e.g. LICOP, Privacy Policies and Financial Services Laws 
• Keep updated with product changes across the business to develop and facilitate product training to claims department
• Support the preparation and proactively manage tender activity for claims
• Identify and lead continuous improvement opportunities to create claims efficiencies 
• Support development and implementation of digital initiatives in line with MetLife and Enterprise Transformation priorities, including System Integration Testing (SIT) and On and Off Platform processes and analysis
• Support the development of training content 
• Develop and deliver communications to the business following digital releases/enhancements 
• Develop and maintain relevant standard operating procedures and claim tools e.g. MIP procedure guides, calculators, eligibility rules engine
• Recognise and prioritise responsibilities in accordance with business needs and ability to work in an agile environment
• Work collaboratively with external and internal stakeholders to drive claims optimisation 

Knowledge/Skills/Competencies Required:

• Work with minimal supervision 
• Knowledge of business strategy and claims philosophies, products and regulatory changes
• Be a committed team player who openly communicates and shares knowledge
• Excellent time management and ability to prioritise work at all times 
• Can work under pressure in an evolving environment
• Ability to adapt to and embrace change
• Strong stakeholder management experience
• Excellent computing skills and literacy 
• Excellent communication skills, both written and verbal
• Ability to manage change

Qualifications/Experience Required:

•  Certifications in Lean, Six Sigma, or related continuous improvement methodologies are advantageous.
• Minimum 3-5 years experience in managing and assessing a claims portfolio and claims technical role (preferred)
• Experience coaching in claims 
• Desirable knowledge across all product lines e.g. Death, Income Protection, TPD, Trauma and Terminal Illness and lines of business e.g. Retail, Corporate and Group.
• Demonstrated understanding of process efficiency and capability to develop processes and procedures
• Strong understanding and working knowledge of applicable regulatory, legislative and Compliance frameworks
• Understanding key data with the ability to analyse and drive insights
• Experience and successful achievements in defining, optimising and redesigning business processes
• Skills and experience working on projects and using agile ways of working

Personal Attributes:

Positive, optimistic, warm, compassionate, confident, patient, calm, fair, honest, respectful of others, has integrity, open, resilient, strong talker and listener, hardworking, team player, leads by example, encourager, self-motivated, supports change in a positive way, owns their culture. Takes ownership and where needed, leadership.

What’s in it for you? 

Flexible & hybrid work arrangements

Fantastic employee benefits including – health & wellbeing allowance, access to corporate discounts through Perks at Work, additional purchased annual leave, super matching and insurances

Access to ongoing professional development, including study support and career progression within a leading global organisation. 

MetLife is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining and maximizing the performance of a diverse and inclusive workforce. It is the policy of MetLife to ensure equal employment opportunity without discrimination or harassment on the basis of race, color, creed, religion, national origin, alienage or citizenship status, age, sex, sexual orientation, gender identity, or expression, marital or domestic/civil partnership status, disability, veteran status, genetic information or any other basis protected by law.

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Tagged as: remote, remote job, virtual, Virtual Job, virtual position, Work at Home, work from home