Claims Operations Manager

Alight Solutions

. Oversee a claims team to meet service goals, operational metrics, and client commitments .

Posted 10/30/2026full-timeRemote • Florida • United StatesMid-LevelSenior💰 $65,000 - $75,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing claims teams and ensuring compliance with legal standards while fostering effective communication across various stakeholders. Proven ability to lead performance management initiatives and develop solutions for complex operational challenges.

Highest-signal resume keywords

Leadership Experience In Claims ManagementExpert Critical Thinking SkillsAdvanced Computer Skills In Microsoft OfficeProven Ability To Manage Day-To-Day ExecutionCreative Agility In Problem Solving

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims ManagementLeave Of Absence ProgramsDocumentation ReviewPerformance ManagementKPI ManagementAnalytical Business AcumenOperational MetricsService Delivery ComplianceWorkload DistributionProject Management

Soft Skills

Excellent Communication AbilitiesRelationship-Building SkillsSupervisory ExperiencePrioritization SkillsTeam Leadership

Tools & Technologies

Microsoft WordMicrosoft ExcelMicrosoft PowerPointMicrosoft OutlookData Analysis ToolsBusiness Tools

Industry Keywords

STD/LTD Product KnowledgeLegal ComplianceClient CommitmentsHealthcare ProvidersEmployee DevelopmentOperational ChangesClient MeetingsBackground Checks

About the role

Key responsibilities & impact

Oversee a claims team to meet service goals, operational metrics, and client commitments
Facilitate communication among Customer Care, Administrative, and Clinical teams, employees, client companies, healthcare providers, and clinical partners for STD and FMLA absence programs
Ensure legal compliance and confidentiality through timely notifications to employees and client organizations
Review documentation supporting claim approvals and denials and respond to audit requests
Act as a Subject Matter Expert for Alight’s Leave of Absence programs
Provide guidance on policies, processes, and client requirements
Ensure accurate, compliant service delivery and help resolve complex cases
Lead a virtual team by defining roles, responsibilities, and accountabilities
Build talent and people capability to support a high-quality culture
Support clients by diagnosing root causes of issues and developing solutions to prevent recurrence
Manage team performance against KPIs and ensure service and performance guarantees are achieved
Oversee workload distribution, performance management, employee development, and goal setting
Respond to client and internal inquiries according to established communication standards
Participate in client meetings and implementations
Monitor staff schedule adherence and communicate new or updated processes, procedures, and operational changes

Requirements

What you’ll need

Leadership experience of three or more years in STD/LTD product and claims management knowledge
Proven ability to manage day-to-day execution and projects to achieve business goals and special assignments
Associate degree or equivalent professional work experience
Excellent communication and relationship-building abilities
Previous supervisory experience and ability to prioritize and assign work
Advanced computer skills using Windows and Microsoft Office suite, including Word, Excel, PowerPoint, and Outlook
Technical proficiency using technology, data, and business tools to foster innovation, boost efficiency, support decision-making, and enhance customer experience
Expert critical thinking skills with proven analytical business acumen
Creative agility to address complex business and technical challenges
Work authorization in the employing country without requiring current or future visa sponsorship
Successful completion of applicable background checks

Benefits

Comp & perks

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
Flexible working arrangements wherever possible
Occasional travel to physical office locations may be required
Competitive total rewards package
Bonus and/or incentive eligibility determined by role and level
Reasonable accommodations for persons with disabilities and sincerely held religious beliefs, practices, and observances