Claims Operations Excellence Manager

3 days ago


Melbourne, Victoria, Australia Medical Indemnity Protection Society Ltd (MIPS) Full time

MIPS is a not-for-profit membership organisation that provides indemnity insurance and other benefits to over a quarter of Australia's doctors as well as dentists and other healthcare practitioners. As a leading player in the insurance industry, we take pride in being a supportive and collaborative place to work and are always looking for passionate and talented people to add to our team.

We are seeking an experienced Claims Transformation Lead – Core Insurance Business Owner who can champion the evolution of our Claims function and drive transformational change. This role is instrumental in ensuring enhanced member experiences, operational efficiencies, and data-driven decision-making while maintaining business continuity.

The successful candidate will have a deep understanding of claims management, strong stakeholder engagement skills, and the ability to balance transformation initiatives with operational needs. They will be responsible for leading the development and validation of business requirements for the Core Insurance Services workstream, with a focus on Claims.

Key Responsibilities:

  • Strategic Leadership
    • Develop and articulate the future vision and target operating model for Claims and quantify expected benefits.
    • Champion transformation across the business, fostering buy-in and support.
    • Lead the development and validation of business requirements for the Core Insurance Services workstream, with a focus on Claims.
    • Represent the workstream in the Transformation Leadership Team and governance forums.
    • Drive post-implementation benefits realisation.
  • Decision Making
    • Makes timely, effective decisions to ensure transformation success.
    • Validates Claims-specific business requirements and process designs.
    • Evaluates vendor proposals against business needs and operational realities.
    • Balances transformation objectives with ongoing operational priorities.
    • Identifies, assesses, and mitigates risks related to Claims and other core insurance services.
    • Develops and implements risk control action plans.
    • Ensures compliance with regulatory requirements in solution design.
    • Assesses operational impacts of proposed changes.
  • Stakeholder Management
    • Engages with key stakeholders across the business to align transformation efforts.
    • Collaborates with the Head of Claims Experience on operational considerations and target operating model.
    • Works effectively with the Program delivery team on planning and implementation.
    • Supports the articulation of Discovery success (recommendations and business value) and supports and leads the transition from Discovery to Implementation phases.
  • Technical Expertise
    • Applies deep claims knowledge to shape future state process designs.
    • (Guides) Develops Claims requirements for core insurance systems.
    • Contributes to solution architecture discussions from a Claims perspective.
    • Participates in market assessments and vendor evaluations.

This is a unique opportunity to make a lasting impact on MIPS and its members by driving meaningful change and innovation in the insurance sector.

We are committed to innovation and growth, and we are looking for a skilled professional who can help us deliver our goals.


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