Remote Claims Operations Leader (Leave & Absence)

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

Job summary

Alight (Alight Solutions Ltd) is seeking a Claims Operations Manager to oversee a claims team, ensure SLA attainment, and align client expectations with team performance. The role requires strategic oversight, engagement, and continuous improvement to drive productivity and customer satisfaction.

You will lead cross-functional collaboration across care, administrative, and clinical functions, ensuring compliant, timely service delivery and effective incident resolution.

Qualifications

• Leadership experience of 3+ years in STD/LTD product and claims management.
• Proven ability to manage day-to-day execution and projects to meet business goals.
• Associate degree or equivalent professional work experience.
• Excellent communication and relationship-building abilities.
• Previous supervisory experience and ability to prioritize and assign work.
• Advanced computer skills across Windows and MS Office suite (Word/Excel/PowerPoint/Outlook).
• Strong analytical thinking and data-driven decision-making skills.
• Creative agility to address complex business challenges.

Responsibilities

• Facilitate communication among Customer Care, Administrative, and Clinical teams and external partners.
• Ensure legal compliance and confidentiality in employee/client communications.
• Review documentation to support claim decisions and respond to audits.
• Act as SME for Leave of Absence programs; guide policies and processes.
• Lead a virtual team, define roles, establish accountability and culture.
• Provide client support using diagnostic skills to identify root causes and propose solutions.
• Monitor team KPIs and ensure service and performance guarantees are met.
• Oversee day-to-day operations: workload, performance, and staff development.
• Respond to client inquiries with professional communication and timely updates.
• Maintain staff schedule adherence and communicate process changes.

Skills

Leadership

STD/LTD knowledge

Client communication

Supervisory experience

Analytical thinking

Education

Associate degree or equivalent

Tools

Microsoft Office

Job description

Alight (Alight Solutions Ltd) is seeking a Claims Operations Manager to oversee a claims team, ensure SLA attainment, and align client expectations with team performance. The role requires strategic oversight, engagement, and continuous improvement to drive productivity and customer satisfaction.

You will lead cross-functional collaboration across care, administrative, and clinical functions, ensuring compliant, timely service delivery and effective incident resolution.