Manager, Appeals – Alight Leave Solutions

This is a fully remote position, open to applicants in Illinois.

📋 Description

• Leading and nurturing a team of Appeals professionals tasked with managing STD and LTD appeals.

• Fostering a positive employee experience while enhancing engagement, retention, and professional growth.

• Overseeing daily operations to ensure that appeal determinations are timely, accurate, and compliant.

• Monitoring performance metrics related to operations, productivity, quality, service levels, and client commitments.

• Coaching, mentoring, and developing team members, while promoting a culture of accountability, collaboration, and continuous improvement.

• Identifying opportunities for process enhancements and collaborating with leadership to implement solutions that boost efficiency and service outcomes.

• Working alongside business partners, compliance, legal, quality, client management, and operational leaders to resolve issues and support business objectives.

• Assisting in the execution of operational strategies, initiatives, and organizational priorities.

• Ensuring compliance with relevant regulatory requirements, policies, procedures, and internal controls.

• Conducting regular team meetings, performance evaluations, and workforce planning activities.

• Aiding in staffing, capacity planning, training, and onboarding efforts to meet business demands.

• Supporting budget goals through efficient resource management and operational discipline.

• Managing escalated appeal cases and providing guidance on complex claims situations.

⛳️ Requirements

• Advanced education or equivalent work experience, along with additional training or certification in DMEC.

• Proven experience in leading a team of Managers within the Appeals sector.

• A minimum of 5 years in claims/appeals and 3 years in leadership roles related to absence management.

• Background in healthcare, rehabilitation, or a medical field through experience, education, and/or designation.

• Lean Six Sigma Certification or formal training in Operations Strategy.

🏝️ Benefits

• Health, dental, and vision coverages starting from Day One.

• Wellbeing programs.

• Retirement plans with contribution matching.

• Generous time off.

• Parental leave.

• Continuing education opportunities.

• Career advancement prospects.

• Flexible working arrangements.