Manager, Appeals-Alight Leave Solutions

Alight•Virtual, IL

2d•$80,000 - $90,000•Remote

About The Position

The Appeals Manager is responsible for leading the day-to-day operations of Alight’s Disability and Absence Management Appeals team. This role oversees the administration and quality of appeals across Short-Term Disability and Long-Term Disability (LTD) programs. The Appeals Manager provides leadership, coaching, and operational oversight to ensure exceptional client service, regulatory compliance, quality outcomes, and team performance.

Requirements

Have advanced education or similar work experience, additional training, and or certification in DMEC.
Possess experience in leadership of a team of Managers within Appeals. This position oversees a total organization or roughly 40 professionals.
Have experience of 5 years in claims/appeals and 3 years leadership in absence management.
Have experience, education and/or designation in a healthcare, rehabilitation, or medical field.
Hold Lean Six Sigma Certification and or formal Operations Strategy training.

Responsibilities

Leading and developing a team of Appeals professionals responsible for STD and LTD appeals. Promoting a positive employee experience while driving engagement, retention, and professional development.
Managing daily operations to ensure timely, accurate, and compliant appeal determinations.
Monitoring operational performance metrics, productivity, quality, service levels, and client commitments. Coaching, mentoring, and developing team members, fostering a culture of accountability, collaboration, and continuous improvement.
Identifying process improvement opportunities and partnering with leadership to implement solutions that improve efficiency and service outcomes.
Collaborating with business partners, compliance, legal, quality, client management, and operational leaders to address issues and support business objectives.
Supporting implementation of operational strategies, initiatives, and organizational priorities.
Ensuring adherence to applicable regulatory requirements, policies, procedures, and internal controls.
Conducting regular team meetings, performance discussions, and workforce planning activities.
Assisting with staffing, capacity planning, training, and onboarding activities to support business needs. Supporting budget objectives through effective resource management and operational discipline.
Managing escalated appeal cases and provide guidance on complex claim situations.