21 Oct
|
MetLife Insurance
|
Sydney
21 Oct
MetLife Insurance
Sydney
We are looking for experienced and driven Senior Case Managers to join us at an exciting time in our digital transformation journey. In this role, you’ll take ownership of a portfolio of complex claims across all benefit types – with a focus on Group Insurance but open to Retail experience – ensuring decisions align with policy intent, our claim philosophy and risk frameworks. You’ll be empowered to exercise sound judgement while delivering SLA’s and CSAT metrics, all within a supportive team culture that values innovation and continuous improvement. This is a unique opportunity to contribute to shaping the future of claims management, where your expertise will help redefine how we support our customers in an increasingly digital world.
As a Senior Case Manager, you will do more than manage claims – you’ll help lead change. We’re seeking someone with strong technical skills who is eager to challenge the status quo and influence how we assess and progress claims. You’ll play a key role in embedding customer-first thinking into our evolving operating model, balancing empathy, efficiency, and compliance. Your insights and experience will directly inform us how we adapt our processes and technology to meet both customer expectations and our community and regulatory obligations.
Technical expertise: Proactively manage and assess a complex portfolio of claims end to end, develop, recommend and implement case management strategies to drive sustainable outcomes and consumer expectations adhering to the policy definitions, philosophies, risk management meeting SLAs and other core claims metrics. You’ll also embrace our evolving digital environment, using technology and data-driven insights to enhance assessment quality and efficiency.
Your expertise will support capability uplift across the team through your solid coaching skills to develop other case managers’ capability in claims handling (financial, medical, eligibility assessments as well as proactive case management strategies) through knowledge sharing and mentoring.
Customer experience and communication: Deliver a customer-first experience by communicating with empathy, clarity, and professionalism across all touchpoints. You’ll tailor your approach to meet the diverse needs of our members and stakeholders, ensuring they feel heard, informed and supported throughout the claims journey. With a strong focus on transparent, timely updates and clear written decisions, you’ll contribute to positive customer outcomes while upholding our brand promise. Your ability to balance compassion with commerciality will be key to maintaining service excellence in a digitally enabled, fast-paced environment.
Delegation of Authority (DA): Holds a mid to high DA at current role consistently passing claim QA reviews of their assigned portfolio/peer reviews
Risk management: Drives and adheres to all claims related regulatory and compliance requirements e.g. LICOP timeframes and set MetLife SLA decision timeframes. Recognise, categorise and prioritise claims in accordance with business needs and Fund partner expectations
Collaboration/culture:
Work collaboratively with all stakeholders (internal and external) to establish and maintain relationships with Claimants, Financial Advisers, Distribution as applicable as well as ability to drive inclusive team culture (strong team player)
Time management:Proven time management skillswith demonstrated ability to prioritise work in a changing environment
Mentor/coaching: Mentor and support Case Managers by sharing technical expertise and fostering critical thinking, while also identifying process or experience improvement opportunities and constructively discussing these with your leader to help them uplift team capability and drive better outcomes
Continuous improvement: Identify opportunities for improvement in claims processes, decision making and customer experience, and proactively engage with your leader to shape and implement enhancements that support a more digital, customer-first, and compliant approach.
Complaints: Respond and manage escalations and complaints relevant to the team’s portfolio
Qualifications and Experience:
Extensive experience (ideally 5+ years) managing complex Group Life Insurance claims across a range of benefit types, including TPD, IP and Death.
Strong working knowledge of policy definitions, trust deed requirements, superannuation legislation, and rehabilitation and return to work strategies within a Group Insurance context.
Proven ability to interpret and apply policy and legislative frameworks while balancing commercial, regulatory and customer outcomes.
Demonstrated capability to manage claims end to end with sound risk assessment, medical and vocational reasoning and stakeholder engagement.
Experience working in alignment
📌 Senior Claims Case Manager (Sydney)
🏢 MetLife Insurance
📍 Sydney