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... For full info follow application link. Alight Solutions provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, pregnancy, childbirth or related medical condition, veteran, marital, parental, citizenship, or domestic partner status, or any other status protected by applicable national, federal, state or local law. Alight Solutions is committed to a diverse workforce and is an