MetLife

We are seeking a senior claims leader to lead MetLife Australia’s Claims Operations and Transformation function. This role is accountable for the strategic leadership, operational performance, governance and continuous improvement of the Claims function, ensuring fair, timely and customer-centric outcomes while balancing commercial sustainability, regulatory obligations and operational efficiency.

As Head of Claims Operations and Transformation, you will lead the end-to-end claims strategy, claims philosophy and claims operating model across individual and group insurance portfolios. You will partner closely with Distribution, Product, Underwriting, Customer Experience, Risk, Legal, Technology, AI and Reinsurance teams to deliver exceptional customer outcomes and support MetLife Australia’s strategic priorities.

This role acts as the executive owner of claims performance, claims governance, regulatory compliance, customer advocacy and industry representation, and also acts as the Product Owner for the claims digital platform, reporting and AI solutions.

Key Responsibilities

Claims strategy and outcomes

• Develop and execute the Claims Strategy and operating model in line with MetLife Australia priorities and customer commitments.
• Ensure claims are managed fairly, consistently and in accordance with policy terms, legislation, regulatory obligations and MetLife’s Claims Philosophy.
• Maintain oversight of complex, high-risk and vulnerable customer matters, with clear escalation and governance pathways.
• Ensuring the Claims Recovery model supports claimants to achieve Return to Work or Return to Wellness outcomes
  
  

Operations, performance and governance

• Own claims service delivery performance, including service levels, quality, turnaround time, customer outcomes, workforce planning and budget management.
• Maintain robust claims governance, escalation and control frameworks for complex, legal, conduct, regulatory and reputational matters.
• Lead engagement with regulatory reviews, audits, risk assessments and remediation activities.

Commercial and stakeholder leadership

• Use claims insights to support portfolio performance, product design, pricing reviews, tender activity and sustainable commercial outcomes.
• Partner with Finance, Actuarial, Product, Distribution, Legal and Reinsurance teams to inform business decisions, pricing and product development.
• Build trusted relationships with superannuation trustees, fund clients, reinsurers, service providers, industry bodies and regulators as required.

People, transformation and innovation

• Lead, develop and inspire the Claims Leadership Team, fostering a culture of accountability, inclusion and high performance.
• Drive continuous improvement, innovation and organisational capability across the Claims function.

• Champion responsible adoption of digital, data, automation and AI-enabled solutions to improve customer, employee and business outcomes with appropriate risk, privacy and human oversight.

Required Qualifications

• Significant senior Claims leadership experience in life insurance, group insurance or related financial services, including leadership of large operational teams.
• Strong understanding of Australian insurance regulations, claims handling obligations, risk, governance, privacy and conduct requirements.
• Demonstrated ability to balance customer outcomes, commercial performance, operational efficiency and regulatory expectations.
• Experience leading change, operational transformation and continuous improvement in a complex stakeholder environment.
• Proven capability to engage credibly with executives, boards or governance forums, trustees, clients, reinsurers, regulators and external partners.
• Strong people leadership capability, including coaching senior leaders, building capability, succession planning and setting clear standards for performance and conduct.
• Commercial, data and digital fluency, including practical understanding of automation, analytics and AI-enabled capability in a controlled environment.
• Demonstrated capability to lead, govern and responsibly leverage AI-enabled productivity, automation and decision-support tools to improve customer, employee and business outcomes, with appropriate risk, privacy and human oversight.
• Tertiary qualification in Business, Law, Insurance, Commerce or a related discipline.
• ANZIIF or equivalent industry certification, or equivalent relevant industry experience.
• Claims Delegation of Authority experience at a previous insurer.

Preferred Qualifications

• Postgraduate qualification in leadership, business or a related discipline.
• Experience in group insurance, superannuation, reinsurance and trustee or fund client environments.
• Experience sponsoring digital, data, automation or claims transformation initiatives.
• Experience representing an organisation in governance forums, industry bodies or regulatory engagement.

MetLife Values and Leadership Expectations

Acts as a role model for MetLife's Values: Win Together, Do the Right Thing, Deliver Impact Over Activity and Think Ahead, while demonstrating the behaviours required to deliver strategy by:

• Applying strong commercial judgement and focusing resources on the outcomes that matter most.
• Prioritising effectively, simplifying complexity and executing with speed and discipline.
• Leveraging technology, AI, data and innovation to improve customer, employee and business outcomes.
• Building capability, fostering collaboration and leading change across the enterprise