Manager, Appeals – Alight Leave Solutions

🔥 2 minutes ago

🌽 Illinois – Remote

🌽 Illinois – Remote

💵 $80k - $90k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

💻 Solutions Engineer

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Alight Solutions

WebsiteLinkedInAll Job Openings

10,000+ employees

🤝 B2B

🏥 Healthcare

☁️ SaaS

💰 $22.5M Post-IPO Secondary - Alight Solutions on 2023-08

B2B • Healthcare • SaaS

Alight Solutions is a leading benefits administration provider that delivers health, wealth, leave, and related HR point solutions for large organizations and their employees. The company helps manage benefits administration and human capital-related processes for enterprises, serving many of the world’s largest organizations and over 30 million people. Alight also emphasizes product and technology roles, corporate sustainability, total rewards, and a focus on transforming lives and organizations by maximizing health, financial and work wellbeing.

📋 Description

• 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.

🎯 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 of 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.

🏖️ Benefits

• health, dental and vision coverages starting Day One • wellbeing programs • retirement plans with contribution matching • generous time off • parental leave • continuing education • career growth opportunities