Senior Claim Operations Manager

Team Leader For Leave And Disability Management

Seeking an experienced team leader skilled in delivering subject matter expertise on client leave and disability policies. Also ensuring exceptional customer service for employees, managers, and clinical leaders.

Our story: At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight."

Our Values:

• Champion People - be empathetic and help create a place where everyone belongs.
• Grow with purpose - Be inspired by our higher calling of improving lives.
• Be Alight - act with integrity, be real and empower others.

It's why we're so driven to connect passion with purpose. Alight helps clients gain a benefits advantage while building a healthy and financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, absence management and navigation.

With a comprehensive total rewards package, continuing education and training, and tremendous potential with a growing global organization, Alight is the perfect place to put your passion to work. Join our team if you Champion People, want to Grow with Purpose through acting with integrity and if you embody the meaning of Be Alight.

About The Role

Responsibilities include coaching, guiding and leading a team of leave and disability managers with varying degrees of claim handling skills. This role will leverage expertise to navigate complex claim handling and payroll workflows. Will oversee work across both Alight's and the client's payroll systems for a premier Fortune 100 client.

Responsibilities

• Managing a dedicated team of leave and disability case managers. Covering a broad scope of leave of absence services including FMLA, company leaves, state leaves, Short Term Disability and Medical (ADAA) Accommodations.
• Collaborating as a positive, enthusiastic, and results-oriented team player with clinical leaders and senior leadership to deliver an exceptional "white glove" service.
• Managing staff to ensure Performance Guarantees are met and review documentation for approvals and denials and respond to periodic audits.
• Leading a remote and hybrid team, defining roles and responsibilities, and establishing direct accountability to achieve business goals. Creating and maintaining a collaborative team focused on effective, high quality client service and trust among the team members.
• Complying with applicable laws and regulations, and documented procedures that incorporate preventive and defective controls. Ensuring legal compliance and confidentiality, providing timely notifications to employees.
• Providing ongoing client support with the use of analytical skills to identify root cause of client claim handling issues. Developing solutions and recommending appropriate actions to prevent recurrence of problems while responding timely and accurately to client and internal inquiries. Acting with regard to established standards with attention to style, tone, and manner of communication.
• Identifying opportunities for continuous improvement in claim handling. Managing processes for leave specialists, disability case managers, and clinical case managers in collaboration with the account Program Director.
• Managing and overseeing workload, performance management, staff schedules, personnel management, established Key Performance Indicators (KPI's) and goal setting for the team. Communicating important information on new and updated processes and procedures to staff.
• Participating appropriately in client meetings and internal claim process improvement meetings and acting as a liaison between all parties and client stakeholders. Facilitating continuous communication, and continued process improvements as applicable in case management.
• Being available for occasional escalations outside of normal business hours via an on-call rotation schedule with MLOA leadership.

Requirements

• Have advanced education and/or designation in healthcare, rehabilitation, or medical field. Work experience of ten + years, training and/or certification in case management, and a minimum of 3 years of claims leadership experience.
• Show the proven ability to manage both day to day execution and projects to achieve results of business goals and special assignments.
• Display excellent interpersonal communications skills both written and verbal. Be dedicated to providing high quality customer service, using diplomacy, patient advocacy, and professional competency.
• Have advanced problem-solving, analytical skills, communication, and client and staff relationship building skills.
• Have management or supervisory experience and the ability to prioritize and assign work.
• Display advanced level computer skills using Windows 2000 and Microsoft Office suite of programs including Word, Excel, PowerPoint and Outlook.
• Hold a Lean Six Sigma Certification and/or formal Operations Strategy training.
• Be adaptable, flexible, and able to lead/manage the team through change. Effectively navigate organizational complexity, understanding the interdependencies and priorities.
• Demonstrate emotional intelligence, adaptability for complex challenges, critical thinking, and advanced business expertise.
• Have experience as an exceptional leader of people who can mentor and build capabilities within a dedicated client team. Demonstrated talent management recruiting and retention strategies.
• Demonstrate a solid understanding of leveraging technology, tools and data to drive innovation, operational improvements and customer experience.

Flexible Working

So that you can be your best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and "Top 100 Company for Remote Jobs" 5 years in a row.

Benefits

We offer programs and plans for a healthy mind, body, wallet and life because it's important our benefits care for the whole person. Options include a variety of health coverage options, wellbeing and support programs, retirement, vacation and sick leave, maternity, paternity & adoption leave, continuing education and training as well as several voluntary benefit options.

By applying for a position with Alight, you understand that, should you be made an offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight's employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.

Our Commitment To Inclusion

We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful. At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrive. Join us in building a brighter, more inclusive future.

As part of this commitment, Alight will ensure that persons with disabilities are provided reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact alightcareers@alight.com.

Equal Opportunity Policy Statement

Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state, or local law. In addition, we take affirmative action to employ disabled persons, disabled veterans and other covered veterans. Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request a reasonable accommodation/modification by contacting their recruiter.

Authorization To Work In The Employing Country

Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not now or in the future require sponsorship of a visa for employment authorization in the Employing Country and with Alight.

Salary Pay Range Minimum: 139,500.00 USD Maximum: 170,500.00 USD Pay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate's experience, education, certification/credentials, market data, internal equity, and geography. Alight makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. Alight also offers a comprehensive benefits package; for specific details on our benefits package, please visit: Wellbeing and Benefits Selector Page - Alight