Claims Manager - Medical Indemnity Professional Conduct Claims

Role Type: 12 Month Fixed Term

Location: Sydney

This role is responsible for the provision of claims management and medico-legal services to Avant and its members in accordance with claims management protocols, legislative requirements and professional medical, legal and ethical standards.

You will manage a portfolio of claims, complaints, investigations and disciplinary matters, develop appropriate management strategies, engage with legal advisers and counsel, and work closely with internal stakeholders to support members throughout the claims process. The role also contributes to member education, risk identification, claims service delivery and continuous improvement initiatives across the organisation.

The Key Responsibilities

• Manage member claims and investigations in accordance with Avant's claims management guidelines and protocols.
• Develop and implement management plans and strategies in response to complaints, disciplinary matters, investigations and other proceedings.
• Explore and utilise alternative dispute resolution opportunities where appropriate.
• Engage and manage external legal advisers and counsel in line with organisational guidelines and direction.
• Review claim estimates and maintain reporting obligations, including government recovery and reinsurance reporting activities.
• Escalate matters that fall outside delegation limits to the Team Manager.
• Review indemnity decisions and work collaboratively with Claims Intake and Underwriting where relevant information may impact indemnity or underwriting decisions.
• Identify members who may benefit from Risk Advisory Services and facilitate appropriate referrals.
• Monitor claims portfolios and contribute to the provision of high-quality claims services.
• Provide support, guidance and knowledge-sharing to Claims Managers and colleagues.
• Design and facilitate educational activities, including articles and presentations on medico-legal, clinical risk and claims-related matters.
• Represent Avant and its members at relevant medical forums.
• Contribute to process improvements, change initiatives and the achievement of departmental objectives.

To Be Successful in This Role You Will Have

• Tertiary qualifications in Law, Health, Business or a related discipline are desirable.
• Current claims management experience, ideally within a medical indemnity environment.
• Knowledge of insurance law and current health and insurance legislation.
• Extensive medico-legal knowledge will be highly regarded.
• Experience coaching, mentoring and supporting colleagues.
• Strong communication, negotiation and advocacy skills.
• The ability to build effective relationships and influence outcomes across a variety of stakeholder groups.
• A customer-focused approach with the ability to understand needs and manage expectations effectively.
• Proficiency using CRM systems, electronic databases and Microsoft Office applications, including Word, Excel and Outlook.
• A Law degree will be highly regarded.

Why work at Avant?

• At Avant, our people are the centre of everything we do for our members. We offer a range of benefits and opportunities to enable you to make a difference, learn, and grow in your career.
• We value our people by offering an inclusive workplace with a diverse range of benefits, flexible working options, career development, and internal mobility opportunities. Our flexible working arrangements are designed to enable genuine work-life balance.
• Your development is our priority and we have a variety of learning and development programs that will support you in your career.
• We offer support to our people via Employee Assistance Program (EAP), Health and Wellbeing programs, Tertiary Education Sponsorship and Support.
• We have a diverse and connected work environment where your contribution and ideas will be valued and respected and make a real difference to the lives of others.

If you require any adjustments during the recruitment process, please don’t hesitate to contact us at ••••@avant.org.au, or call Jack Dingle on 04•••••841