Job Title

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 gaps and develop plans to address; anticipating future trends and challenges, developing and implementing strategies to address opportunities. Assessing and evaluating business/technology partners to integrate products on various platforms and recommending 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 and 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 has been maintained; complying with applicable laws and regulations and documented procedures that incorporate preventive and defect controls, partnering with Regulatory Compliance and Risk Committees. 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. Salary Pay Range: Minimum: 110,000.00 USD; Maximum: 130,000.00 USD Alight is an Equal Employment Opportunity employer and does not discriminate against anyone based on sex, race, color, religion, creed, national origin, ancestry, age, physical or mental disability, medical condition, pregnancy, marital or domestic partner status, citizenship, military or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state, or local law. In addition, we take affirmative action to employ disabled persons, disabled veterans, and other covered veterans. Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not, now or in the future, require sponsorship of a visa for employment authorization in the Employing Country and with Alight. #J-18808-Ljbffr