Claims Operations Manager - Virtual

Our Story At Alight, we believe a company's success starts with its people. Alight embraces values that come directly from our people - purposeful, human, united and growth-minded - reflecting our inclusive culture and promise that our clients expect. We are passionate about connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence management. Our Benefits With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and vision coverages starting Day One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities - all within a thriving global organization. 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" 6 years in a row. Great Place to Work Thanks to the work of every colleague, Alight has received multiple awards of recognition including "Great Place to Work" for the past 7 years and Fortune's "Best Companies to Work For." To learn more about our company culture and awards Click Here. We invite you to join our team! Learn more at careers.alight.com. About the Role The Claims Operations Manager oversees a claims team, ensuring service goals, operational metrics, and client commitments are met. This role emphasizes strategic oversight, accountability, engagement, and continuous improvement. They align corporate objectives with client expectations and team performance to achieve productivity, SLA, quality, and customer satisfaction targets. Responsibilities Facilitating communication among the Customer Care, Administrative, and Clinical teams. This would extend to employees, client companies, healthcare providers, and clinical partners, for STD and FMLA absence programs. Ensuring legal compliance and confidentiality by providing timely notifications to employees and client organizations. Reviewing documentation to support claim approvals and denials and responding to audit requests in accordance with regulatory and company requirements. Acting as a Subject Matter Expert for Alight's Leave of Absence programs, offering guidance on policies, processes, and client requirements. Ensuring accurate, compliant service delivery and assisting with resolving complex cases. Leading a virtual team, defining roles and responsibilities and establishing direct accountabilities to achieve business goals. Building talent and people capability to enable a high-quality culture. Providing ongoing client support with the use of diagnostic skills to identify root cause of client issues. Developing solutions and recommending appropriate action to prevent recurrence of problems. Managing team performance against established Key Performance Indicators (KPIs) and ensuring all service and performance guarantees are consistently achieved. Overseeing day-to-day operations, including workload distribution, performance management, employee development, and goal setting to drive business results. Responding timely and accurately to client and internal inquiries, according to established standards with attention to style, tone, and manner of communication. Participating appropriately in client meetings and implementations. Monitoring and maintaining staff schedule adherence while ensuring timely communication of new an updated processes, procedures, and operational changes. Requirements 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 results of 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. Application and Interview 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. Alight requires all virtual interviews to be conducted on video. Please be aware that Alight is a camera-on culture and may require occasional travel to one of our physical office locations. 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 [email protected]. 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 reasonable accommodations/modifications by contacting their recruiter. Authorization to wor