Claims Operations Director- Appeals-Alight Leave Solutions

Alight Solutions

2d • Remote

About The Position

Amazing Opportunity and Great Place to Work! Our story At Alight, we believe a company’s success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to “Be Alight.” 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. If you, Champion People, seek to Grow with Purpose, and embody the meaning of Be Alight – We invite you to join our team! Learn more at careers.alight.com.

Requirements

• Possess advanced education, equivalent work experience, training, or DMEC certification.
• Have experience of 10 years in claims/appeals and 7 years leadership in absence management.
• Display qualifications or experience in healthcare, rehabilitation, or a medical field.
• Hold Lean Six Sigma Certification and or formal Operations Strategy training.
• Have experience in leadership of a team of Managers within Appeals.
• This position oversees a total organization or roughly 40 professionals.

Responsibilities

• Leading LOA, STD, ADA, and/or LTD Appeals service teams.
• Developing strategy and business plans to deliver market-centric capabilities and processes.
• Working with broader organization and external parties to identify and gaps and develop a plan to address.
• Anticipating future trends and challenges, developing and implementing strategies to address opportunities.
• Assessing and evaluated business/technology partners to integrate products on various platforms.
• Developing and recommended Claims and Service level strategies and tactics.
• Demonstrating expertise in accurate Appeals Claim Management.
• Collaborating with peers and senior leadership to deliver exceptional service.
• Managing Appeals departmental budget and plan effectively for responsible growth.
• Enhancing the Claims team through regular business updates to ensure alignment with organizational goals.
• Fostering a culture of trust within the team.
• Establishing performance metrics with clear systems of measures and accountabilities that drive results.
• Ensuring that an effective system of regulatory compliance and internal controls have been maintained.
• Complying with applicable laws and regulations, and documented procedures that incorporated preventive and defective controls.
• Partnering with Regulatory Compliance and Risk Committees.

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.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed