Care Case Manager - Complaints & Claims

MetLife Australia; Sydney; On-site; AUD 110,000 - 165,000; Full time

Benefits offered by this job

Life insurance

Parental leave

Menopause and fertility leave

Car leasing

Employee Assistance Program (EAP)

360Health medical support

Volunteer leave

Study assistance

Job summary

MetLife Australia is seeking a Care Case Manager for Complaints & Claims Continuity in Sydney. You will coordinate escalated AFCA matters from inception to final resolution, ensuring priority, accountability and customer focus across Claims and Customer Relations.

The role requires strong experience in complaints or claims management, deep understanding of dispute resolution frameworks and diligent privacy handling, with a focus on continuous improvement and stakeholder collaboration.

Qualifications

• Experience in complaints management or claims management within a regulated environment.
• Understanding of Internal Dispute Resolution and External Dispute Resolution frameworks.
• Knowledge of privacy obligations and handling of sensitive information.

Responsibilities

• Manage end-to-end portfolio of escalated complaints and AFCA matters with ownership and visibility.
• Monitor regulatory deadlines, AFCA requests, and determinations; escalate overdue items.
• Coordinate activities across Claims, Customer Relations, Legal, Privacy, Risk and Compliance.
• Prepare and coordinate documentation for external disclosure with privacy and redaction checks.
• Maintain timely communication with customers, AFCA and internal stakeholders with a clear case narrative.
• Track agreed outcomes to completion, including payments and document submissions.
• Identify recurring themes to support reporting, root-cause analysis and improvement initiatives.
• Ensure compliance with Regulatory Guide 271 and Life Insurance Code of Practice.

Skills

Complaints management

Claims management

AFCA process

Dispute resolution

Stakeholder coordination

Regulatory compliance

Tools

AFCA portals

Case management systems

Workflow tools

Job description

The Care Case Manager, Complaints & Claims Continuity is responsible for the end-to-end coordination and continuous oversight of escalated complaints and claim-related Australian Financial Complaints Authority matters, from Internal Dispute Resolution acceptance through to final resolution and implementation.

Guided by our purpose, always with you, building a more confident future, and our New Frontier strategy focused on stronger growth, attractive returns and all-weather performance, this role ensures complex matters continue to progress across operational teams without losing priority, accountability or customer focus.

Acting as a central point of coordination across Claims, Customer Relations and supporting business functions, you will ensure all claim actions, customer communications, payments, document submissions and agreed outcomes are completed and verified before a matter is closed.

This role does not replace the accountability of claim or complaint decision-makers. Instead, it provides continuity, oversight and execution support throughout the lifecycle of each matter.

Key Responsibilities

• Manage the end-to-end operational portfolio of escalated complaints and claim-related AFCA matters, maintaining clear ownership, action tracking and progress visibility from allocation through to closure.
• Monitor regulatory deadlines, AFCA requests, conciliations, conferences, Preliminary Assessments, determinations and agreed actions, escalating overdue responses, ageing matters, incomplete documentation and delivery risks.
• Coordinate activities across Claims, Customer Relations, Review Panels, Legal, Privacy, Risk, Governance and Compliance, ensuring responsibilities, timelines and dependencies are clearly understood.
• Prepare and coordinate documentation for external disclosure, ensuring information is complete, accessible, appropriately formatted and subject to the required privacy, redaction and quality checks.
• Maintain consistent and timely communication with customers, AFCA and internal stakeholders, while ensuring a clear case narrative is maintained throughout the matter.
• Track all agreed outcomes through to completion, including claim reviews, customer correspondence, payments, document submissions, workflow updates and system actions.
• Challenge incomplete, unclear or unworkable outcomes and ensure matters are not closed until all commitments and required actions have been completed and evidenced.
• Identify recurring complaint themes, operational breakdowns and systemic issues, contributing insights to reporting, root-cause analysis and continuous improvement initiatives.
• Support compliance with Regulatory Guide 271, the Life Insurance Code of Practice, AFCA requirements, privacy obligations and internal service standards.
• Use digital and AI-enabled productivity tools responsibly to support case tracking, document preparation, workflow management and reporting, while maintaining appropriate human oversight, confidentiality and accountability.

Required Qualifications

• Demonstrated experience in complaints management, claims management, AFCA complaints, dispute resolution or complex case management.
• Strong understanding of Internal Dispute Resolution and External Dispute Resolution frameworks, regulatory obligations and customer resolution principles.
• Knowledge of privacy obligations and the appropriate handling, disclosure and redaction of sensitive customer and claims information.
• Proven ability to coordinate complex or long-running matters involving multiple stakeholders, dependencies and competing priorities.
• Strong workflow management, administration and organisational capability, with the ability to maintain momentum and accountability across multiple matters.
• High attention to detail, particularly in relation to documentation, quality assurance, regulatory deadlines and implementation of agreed outcomes.
• Strong written and verbal communication skills, including the ability to engage customers and influence senior internal stakeholders.
• Demonstrated proficiency in using digital tools and AI-enabled productivity solutions to support administration, information management and workplace efficiency, with a commitment to responsible and ethical use.

Preferred Qualifications

• Experience managing claim-related AFCA matters from allocation through to final resolution and implementation.
• Experience within life insurance, financial services, claims or another highly regulated customer environment.
• Familiarity with AFCA portals, case management systems, workflow tools and regulatory reporting processes.
• Experience coordinating privacy reviews, document redaction, external submissions or sensitive information disclosure.
• Experience contributing to complaints reporting, root-cause analysis, remediation or continuous improvement initiatives.

Benefits We Offer

When you join MetLife Australia, you are joining a company that demonstrates holistic care and wellbeing for employees with benefits and programs that address physical, mental, social and financial health.

• life insurance benefits
• generous paid parental leave
• market leading menopause and fertility leave
• car leasing
• Employee Assistance Program (EAP)
• access to 360Health medical support
• volunteer leave
• study assistance

About MetLife

Recognised on Fortune magazine's list of the "World's Most Admired Companies", Fortune World’s 25 Best Workplaces™, as well as the Diversity Council of Australia Inclusive Employer Award, MetLife, through its subsidiaries and affiliates, is one of the world’s leading financial services companies; providing insurance, annuities, employee benefits and asset management to individual and institutional customers. With operations in more than 40 markets, we hold leading positions in the United States, Latin America, Asia, Europe, and the Middle East.

As part of our New Frontier strategy, MetLife is building an AI-enabled, people-centered future. We’re looking for people who bring curiosity, adaptability, and a growth mindset as we use AI to enhance how we serve customers, support communities, and evolve the way work gets done. At MetLife, AI is a responsible partner that supports human judgment, creativity, and continuous improvement while helping us build trust, inclusion, and long-term value.

Our purpose is simple - to help our colleagues, customers, communities, and the world at large create a more confident future. United by purpose and guided by our core values - Win Together, Do the Right Thing, Deliver Impact Over Activity, and Think Ahead - we’re inspired to transform the next century in financial services. At MetLife, it’s #AllTogetherPossible . Join us!