Work options
Hybrid
Role Overview
The Manager, Claims Performance & Strategic Review is responsible for providing strategic oversight, governance, and performance management across time loss workers compensation claims. The role ensures claims are managed effectively, consistently, and in line with legislative and organisational expectations, with a focus on improving decision quality, strengthening case management capability, and enhancing overall claims outcomes.
The role plays a key part in identifying emerging risks and trends, driving performance improvement, and maintaining confidence with internal stakeholders and external partners within the workers compensation scheme.
Claims Oversight & Performance
* Provide oversight of time loss workers compensation claims to ensure quality, consistency, and adherence to scheme and organisational requirements
* Monitor claims performance, identifying trends, risks, and areas for improvement
* Drive initiatives to improve claims outcomes, including return to work, cost management, and claim duration
Strategic Review & Risk Management
* Conduct strategic reviews of complex or high-risk claims to ensure appropriate decision-making and risk mitigation
* Identify emerging risks and systemic issues, providing recommendations to improve performance and reduce exposure
* Ensure alignment with workers compensation legislation, regulatory expectations, and internal policies
Management Responsibilities
* Provide leadership and direction to indirect reports, fostering a high-performance, accountable, and collaborative team culture
* Set clear performance expectations and monitor outcomes, ensuring alignment with organisational objectives and claims strategy
* Coach and mentor team members and case managers, building technical expertise and decision‐making capability
* Lead performance conversations where required, addressing underperformance and recognising strong contribution
Governance & Assurance
* Establish and maintain governance frameworks to support effective claims oversight and decision quality
* Provide assurance that claims are being managed in line with agreed standards, processes, and controls
* Support audit activity and ensure findings are addressed and embedded
Capability & Continuous Improvement
* Strengthen case manager capability through insights, feedback, and targeted interventions
* Identify opportunities to improve claims processes, tools, and ways of working
* Drive a culture of continuous improvement and accountability across claims management
Stakeholder Management
* Build and maintain strong relationships with internal stakeholders, insurers, and external partners
* Provide clear, evidence‐based insights and recommendations to support decision‐making
* Maintain confidence and alignment across stakeholders on claims strategy and performance
Skills And Experience Required
* Significant experience in managing workers compensation claims
* Significant experience with relationship management in an insurance context
* Demonstrable experience with analysing claims performance and trends
* Strong technical knowledge of workers compensation legislation (VIC and NSW experience preferred), claims frameworks, and regulatory requirements
* Advanced understanding of liability, work capacity, and injury management principles across complex claims
* Demonstrated ability to interpret complex medical, factual, and vocational evidence, and translate insights into clear, actionable recommendations
* High‐level analytical capability, with strong judgement and decision‐making in complex and sensitive claim scenarios
* Proven ability to coach, influence, and uplift capability across claims teams and external providers
* Experience in people leadership, mentoring and coaching preferred
* Experience operating in stakeholder‐facing, assurance‐focused environments, with the ability to provide independent oversight and challenge constructively
* Strong stakeholder management and communication skills, with the ability to engage credibly across internal teams, insurers, and external partners
* A qualification or certification in a health, workers' compensation or business‐related field is highly desirable
* Experience using SIMS (claims management system)
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