Remote Claims Ops Manager: Leave & Absence Expert

Alight Solutions; Belleville (IL); Hybrid; USD 65,000 - 75,000; Full time

Job summary

Alight Solutions is seeking a Claims Operations Manager to lead a claims team, align with client expectations, and drive productivity, SLA, quality, and customer satisfaction. The role emphasizes strategic oversight, engagement, and continuous improvement within a flexible, globally distributed organization.

Responsibilities include cross-functional coordination, compliance, documentation review, expert guidance on leave programs, and performance management to meet business goals.

Qualifications

• Have leadership experience of three or more years in STD/LTD product and claims management knowledge.
• Demonstrate the proven ability to manage both day-to-day execution and projects to achieve business goals and special assignments.
• Possess an associate degree or equivalent professional work experience.
• Display excellent communication and relationship-building abilities.
• Have previous supervisory experience and the ability to prioritize and assign work.
• Have advanced level computer skills using Windows and Microsoft Office suite of programs including Word, Excel, PowerPoint and Outlook.
• Show technical proficiency by utilizing technology, data, and business tools to foster innovation, boost efficiency, support decision-making, and enhance customer experience.
• Display expert critical thinking skills with proven analytical business acumen.
• Have creative agility to address complex business and technical challenges.

Responsibilities

• Facilitating communication among the Customer Care, Administrative, and Clinical teams and with employees, client companies, healthcare providers, and clinical partners.
• Ensuring legal compliance and confidentiality by providing timely notifications to employees and client organizations.
• Reviewing documentation to support claim approvals/denials and responding to audit requests.
• Acting as a Subject Matter Expert for Alight's Leave of Absence programs and advising on policies and client requirements.
• Leading a virtual team, defining roles and establishing direct accountabilities to achieve goals.
• Providing ongoing client support with diagnostic skills to identify root causes and propose solutions.
• Managing team performance against KPIs and maintaining service and performance guarantees.
• Overseeing day-to-day operations, workload distribution, performance management, and staff development.
• Responding to client and internal inquiries with proper tone and style; participating in meetings and implementations.
• Monitoring staff schedule adherence and communicating updates to processes and procedures.

Skills

Leadership

Communication

Supervisory experience

MS Office

Analytical ability

Project management

Education

Associate degree or equivalent

Tools

MS Office

Windows

Job description

Alight Solutions is seeking a Claims Operations Manager to lead a claims team, align with client expectations, and drive productivity, SLA, quality, and customer satisfaction. The role emphasizes strategic oversight, engagement, and continuous improvement within a flexible, globally distributed organization.

Responsibilities include cross-functional coordination, compliance, documentation review, expert guidance on leave programs, and performance management to meet business goals.