Remote Claims Operations Leader

Alight Solutions Ltd; Nebraska; On-site; USD 65,000 - 75,000; Full time

Job summary

Alight Solutions is seeking a Claims Operations Manager to oversee a claims team, ensuring service goals and client commitments are met with strategic oversight and continuous improvement. You will align corporate objectives with team performance to achieve productivity, SLA, quality, and customer satisfaction targets.

The role requires leadership with 3+ years in STD/LTD claims, supervisory experience, and strong communication.

Qualifications

• Leadership experience of three or more years in STD/LTD product and claims management knowledge.
• Proven ability to manage day-to-day execution and projects to achieve business goals.
• Associate degree or equivalent professional work experience.
• Excellent communication and relationship-building abilities.
• Previous supervisory experience and the ability to prioritize and assign work.
• Advanced level computer skills with Windows and the Microsoft Office suite.
• Technical proficiency using data and business tools to improve decisions and customer experience.
• Strong analytical thinking and business acumen.
• Creative agility to address complex business and technical challenges.

Responsibilities

• Facilitate communication among Customer Care, Administrative, and Clinical teams.
• Ensure legal compliance and confidentiality in communications and documentation.
• Review documentation to support claim approvals/denials and respond to audits.
• Serve as Subject Matter Expert for Leave of Absence programs and policies.
• Lead a virtual team with clear roles and accountabilities to meet goals.
• Develop solutions and preventive actions based on root-cause analysis.
• Monitor KPIs and ensure service and performance guarantees are met.
• Oversee day-to-day operations, including workload distribution and staff development.
• Respond promptly to client and internal inquiries and participate in client meetings.

Skills

Leadership

STD/LTD claims

Supervisory experience

MS Office proficiency

Communication skills

Education

Associate degree

Job description

Alight Solutions is seeking a Claims Operations Manager to oversee a claims team, ensuring service goals and client commitments are met with strategic oversight and continuous improvement. You will align corporate objectives with team performance to achieve productivity, SLA, quality, and customer satisfaction targets.

The role requires leadership with 3+ years in STD/LTD claims, supervisory experience, and strong communication.