Senior Claims Excellence Manager

About Avant

Avant is Australia’s leading medical defence organisation with a proud heritage of protecting Australian medical professionals for over 130 years. It was established by a small group of doctors in 1893, who wanted to “protect themselves from actions arising out of the practice of medicine”.

Avant now represents 82,000 health practitioners and medical students across every state and territory, delivering market leading products and services to meet their professional, personal and practice needs. Building on this heritage, our vision is to be the most trusted professional partner in supporting doctors throughout their lives and careers.

As a mutual organisation, owned by members and run purely for their benefit, our members are at the centre of all we do. As well as providing products and services to our members, we play a broader community role by advocating for improvements in the healthcare system and in quality, safety and professionalism in medicine, through delivering education and research activities.

The commitment to members and the profession from our 850 staff has resulted in over 50% of Australia’s doctors choosing to be Avant members, delivered annual revenues of $440 million and net assets of $1.4 billion.

About the Role

This leadership role has accountability for setting process and performance standards and developing and delivering the artefacts and tools to enable adherence and quality. Critically, this role facilitates the identification of member and employee pain points, or process breakdowns, and governing improvement opportunities to uplift operational standards for National Claims within Medical Indemnity.

Reporting to the Head of Claims Operations and Excellence, and delivering services to Claims Operations, Claims Management and Legal functions, this role works closely with the Senior Manager, Claims Operations, Heads of Practice and other key stakeholders across Avant in meeting the set strategic Claims & Legal objectives. Ensuring the teams can deliver on the ‘Exceptional for Member’ experience outcomes, through end to end claims experience, including meeting our member promise of being Honest. Expert. Responsive. Easy.

Day to Day, this role leads the Claims Excellence functions that sets process standards and outcomes, closely monitors, reports and improves the process and systems standards driving the end-to-end claims and legal processes managed internally or by our external legal panel.

This role is critical to MI Strategic direction and has considerable scope to execute and embed change across people, process and technology domains.

Claims Excellence Capability

- Supporting the Claims and Legal Leadership team in monitoring performance against balanced scorecard and key performance indicators, in line with strategic objectives. Identifying opportunities in people, process or systems that will improve customer, employee or business performance measures.

- Providing governance and oversight of improvement opportunities to uplift customer, employee or performance outcomes.

- Build and maintain cross functional relationships throughout Claims, Legal, Medical Advisory and broader Medical Indemnity teams to ensure effectiveness of Claims Excellence function.

- Drive, lead and develop the Claims Excellence Team Members with the objective of setting the standards, monitoring effectiveness, and ensuring supporting mechanisms/ systems are aligned for all claims and legal services. Including:

- Portfolio Management Reporting and Insights

- Advice Standards and knowledge management

- Process and Systems Improvements

- Quality Assurance and auditing across claims and legal processes (internal and external)

- Professional education and training coordination

- Drive and manage external legal panel relationships, including the review of performance against agreed service levels.

- Draw on and utilise existing frameworks and standards set within the Business Change and Excellence functions to ensure Claims Excellence activities are strategically and operationally aligned with Avant, Medical Indemnity.

- With the Head of Claims Operations and Excellence and Senior Manager Claims Operations set culture and people engagement for the Claims Operations and Excellence team.

- Support team and individual performance goals.

- Succession planning and talent development.

- With broader excellence focus, input into and execute Claims Excellence People Plan.

- Ensure team members are trained and Knowledge Management kept current.

- Span of control ~6 FTE

Member Focus

- Ensure teams can live to our member promise – HERE principles in full.

Key capabilities or experiences required to perform the role

- 3+ years Business Operations Design experience critical, inc: Process design, development, improvement, implementation, systems, reporting etc.

- Insurance, Claims and, or Operations experience critical.

- Stakeholder management, Strong relationship building capabilities.

- Understand operational reporting requirements to drive performance in line with objectives and key results.

- Experience managing member experience and complaints management.

- Understanding of national insurance and medico legal specific regulators and legal frameworks.

- Ability to drive outcomes aligned to KPI/STI Objectives.

Equal Opportunity Employer

Avant supports doctors so they can serve Australia's diverse communities. Having diversity in our workforce brings valuable perspectives and strengthens our ability to support healthcare professionals.

We therefore welcome applications from people of all backgrounds, including Aboriginal and Torres Strait Islander peoples, people from culturally diverse communities, LGBTQIA+ individuals, people with disabilities, and those with caring responsibilities.

Our inclusive workplace is somewhere everyone can succeed.

Ready to join us?

If you're passionate about supporting Australia's healthcare professionals, we'd love to hear from you. If you require any adjustments during the recruitment process, please don't hesitate to contact us at careers@avant.org.au

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