About the role The Claims Manager oversees operational function of the Claims team, including clerical work within the Operational teams in DHF. They supervise day-to-day Claims activities, coordinate and scheduling of resources, and lead teams of Claims specialist and assessors. The role is focused on achieving operational excellence, managing resources effectively, ensuring compliance and communication, and mitigating risks to support organisational goals. The principal purpose of the position: Oversee the claims interactions between the fund and its customers and providers Manage the private health insurance: benefit payments; provider relationships; and products Progressively drive an agenda of the fund as a trusted advisor and thought leader Drive a culture of efficiency, quality and risk management Lead an engaged, skilled and high performing team Key accountabilities: The efficient and effective operation of the claims assessing function Ensuring compliance with company policies, procedures, and legislative regulation in all administrative activities. Addressing operational issues promptly and effectively, using analytical and problem-solving skills. Reporting: Providing regular reports and updates to senior management on operational performance, challenges, and achievements. Building and leading a high performing team enabling the fund to meet strategic goals Experience and skill required: Personal attributes and competencies Ability to lead and motivate the Administrative and Claims team. Effective decision-making and problem-solving skills. Strong ability to prioritise tasks and manage multiple projects simultaneously. Attention to detail and accuracy in all claims activities. Excellent written and verbal communication skills. Ability to communicate effectively with various stakeholders, both internal and external. Strong problem-solving skills with a focus on continuous improvement. Experience in recruiting, training, and developing Claims team. Ability to foster a collaborative and productive team environment. Flexibility to adapt to changing priorities and business needs. Experience Experienced in streamlining workflows and enhancing operational efficiency. Proven experience in managing administrative functions, preferably in a similar operational setting. Understanding of regulatory requirements and experience in ensuring compliance with policies and procedures. Knowledge of administrative procedures, practices, and systems. Demonstrated success in leading and developing a team of administrative professionals. Experience in setting goals, monitoring performance, and providing feedback.
