Senior Claims & Leave Ops Lead - Remote

Alight Solutions Ltd; Michigan; Hybrid; USD 65,000 - 75,000; Full time

Benefits offered by this job

Flexible working arrangements

Travel opportunities

Job summary

Alight Solutions Ltd is seeking a Claims Operations Manager to oversee a claims team, ensuring service goals, KPIs, and client commitments are met. This role emphasizes strategic oversight, accountability, and continuous improvement aligned with client expectations.

The role requires leadership experience in STD/LTD claims, strong communication skills, and a background in managing day-to-day operations and projects.

Qualifications

• Lead a claims team to meet service goals and client commitments.
• Demonstrate ability to manage day-to-day execution and projects.
• Strong communication and relationship-building abilities.
• Experience in STD/LTD product and claims management.

Responsibilities

• Facilitate communication among Customer Care, Administrative, and Clinical teams.
• Ensure compliance and confidentiality in notifications to employees/clients.
• Review documentation to support claim approvals/denials and respond to audits.
• Act as Subject Matter Expert for Leave of Absence programs and client requirements.
• Lead a virtual team, define roles, and build talent to enable a high-quality culture.
• Provide ongoing client support and diagnose root causes of issues to prevent recurrence.
• Monitor KPIs and ensure service guarantees are achieved.
• Oversee day-to-day operations, including workload and performance management.
• Respond to client/internal inquiries with professional communication.
• Maintain staff schedule adherence and communicate process changes.

Skills

Leadership experience in STD/LTD/CLAIM

Communication

Supervisory experience

Education

Associate degree or equivalent

Tools

Windows

Microsoft Office

Job description

Alight Solutions Ltd is seeking a Claims Operations Manager to oversee a claims team, ensuring service goals, KPIs, and client commitments are met. This role emphasizes strategic oversight, accountability, and continuous improvement aligned with client expectations.

The role requires leadership experience in STD/LTD claims, strong communication skills, and a background in managing day-to-day operations and projects.