Team Leader - Claim Approvals

Southern Cross Health Insurance; Hamilton; On-site; CAD 124,000 - 166,000; Full time

Job summary

Southern Cross Health Insurance is seeking a dedicated leader for a 12-month secondment to head our Claim Approvals team. You will guide up to 12 consultants, drive capability, performance and ensure exceptional service and fair outcomes for members and providers.

The role focuses on people leadership, process excellence and stakeholder collaboration within a busy claims environment, with emphasis on continuous improvement and compliant operations.

Qualifications

• Proven experience leading and developing teams in customer service, contact centre, claims, insurance or financial services.
• Strong leadership with coaching, mentoring and building high-performing teams.
• Ability to manage escalated and complex customer enquiries while supporting the team.
• Knowledge of policies, procedures, risk and compliance requirements.
• Experience with QA reviews and using insights to improve outcomes.
• Excellent communication and stakeholder management across levels.
• Growth mindset and continuous improvement focus.
• Experience in insurance/health insurance or financial services is advantageous.

Responsibilities

• Lead, coach and develop a high-performing team to meet service levels and KPIs.
• Build team capability through mentoring and structured development conversations.
• Manage complex member enquiries, escalations and complaints with timely resolutions.
• Perform quality assurance and identify opportunities to improve performance and outcomes.
• Ensure decisions align with policy, risk, compliance and fair customer outcomes.
• Support change initiatives and system enhancements across the wider Member Services function.
• Foster a positive, engaged and inclusive team culture where people succeed.

Skills

People leadership

Team coaching

Customer service

Insurance knowledge

Quality assurance

Job description

About Us

Southern Cross Health Insurance is shaping a healthier Aotearoa New Zealand. Our purpose is simple: empowering our members to live well for longer. We're here to give peace of mind through timely access to quality care, inspire healthier living, and lead positive change across the health system. As a New Zealand-owned, member-based organisation, we're building a future where wellbeing is at the heart of everything we do -- delivering exceptional value for our members and creating an environment where our people thrive.

Now is an exciting time to join us. You'll be part of a high-performing, values-driven team where people are at the heart of everything we do -- and in return for your talent, you'll have the opportunity to grow, make an impact, and be proud of the difference your work makes.

About Us

Southern Cross Health Insurance is shaping a healthier Aotearoa New Zealand. Our purpose is simple: empowering our members to live well for longer. We're here to give peace of mind through timely access to quality care, inspire healthier living, and lead positive change across the health system. As a New Zealand-owned, member-based organisation, we're building a future where wellbeing is at the heart of everything we do -- delivering exceptional value for our members and creating an environment where our people thrive.

Now is an exciting time to join us. You'll be part of a high-performing, values-driven team where people are at the heart of everything we do -- and in return for your talent, you'll have the opportunity to grow, make an impact, and be proud of the difference your work makes.

About The Role

This is an exciting 12-month secondment opportunity to lead one of our Claim Approvals teams. Leading a team of up to 12 consultants, you'll play a key role in building capability, driving performance, and ensuring our members and providers receive exceptional service and fair outcomes.

In This Role, You Will

• Lead, coach and develop a high-performing team to achieve service levels, quality standards and operational KPIs.
• Build team capability through ongoing mentoring, technical coaching and structured development conversations.
• Manage complex member enquiries, escalations and complaints, ensuring timely and effective resolution.
• Perform quality assurance activities and identify opportunities to improve team performance, customer outcomes and operational efficiency.
• Ensure decisions and processes align with policy requirements, risk frameworks, compliance obligations and fair customer outcomes.
• Support business change initiatives, system enhancements and continuous improvement activities across the wider Member Services function.
• Foster a positive, engaged and inclusive team culture where people feel supported to succeed.

About You

We're looking for an experienced leader who can confidently balance people leadership, operational excellence and customer outcomes.

To Be Successful In This Role, You'll Bring

• Proven experience leading and developing teams in a customer service, contact centre, claims, insurance or financial services environment.
• Strong people leadership skills with a track record of coaching, mentoring and building high-performing teams.
• The ability to confidently manage escalated and complex customer enquiries while supporting your team through challenging situations.
• Strong knowledge of policies, procedures, operational risk and compliance requirements.
• Experience conducting quality assurance reviews and using insights to improve performance and customer outcomes.
• Excellent communication and stakeholder management skills, with the ability to build trust and influence across all levels of the business.
• A growth mindset, strong problem-solving capability and a passion for continuous improvement.
• Previous experience within the insurance, health insurance or broader financial services sector will be highly regarded.

We are proud to have taken the Pride Pledge, reflecting our commitment to inclusion and belonging. We also facilitate an active, employee‑led Diversity, Equity and Inclusion Forum, which includes our Rainbow Network, Māori Network, Pasifika Collective, and Neurodiversity and Whānau Support networks.

If you share our commitment and passion, we'd love to hear from you.