Strada · 1 month ago
Senior Claim Operations Manager
US-NJ-New Jersey-Virtual
Full-time
Hybrid
Senior Level, Lead/Staff
$140K/yr - $170K/yr
10+ years expAlight Solutions is a global organization dedicated to improving lives through a comprehensive benefits ecosystem. They are seeking a Senior Claim Operations Manager to lead a team of claims professionals, ensuring exceptional customer service while navigating complex claim handling and payroll workflows.
AdviceBookkeeping and PayrollBusiness DevelopmentConsulting
No H1B
Responsibilities
Managing a dedicated team of leave and disability case managers. Covering a broad scope of leave of absence services including FMLA, company leaves, state leaves, Short Term Disability and Medical (ADAA) Accommodations
Collaborating as a positive, enthusiastic, and results-oriented team player with clinical leaders and senior leadership to deliver an exceptional “white glove” service
Managing staff to ensure Performance Guarantees are met and review documentation for approvals and denials and respond to periodic audits
Leading a remote and hybrid team, defining roles and responsibilities, and establishing direct accountability to achieve business goals. Creating and maintaining a collaborative team focused on effective, high quality client service and trust among the team members
Complying with applicable laws and regulations, and documented procedures that incorporate preventive and defective controls. Ensuring legal compliance and confidentiality, providing timely notifications to employees
Providing ongoing client support with the use of analytical skills to identify root cause of client claim handling issues. Developing solutions and recommending appropriate actions to prevent recurrence of problems while responding timely and accurately to client and internal inquiries. Acting with regard to established standards with attention to style, tone, and manner of communication
Identifying opportunities for continuous improvement in claim handling. Managing processes for leave specialists, disability case managers, and clinical case managers in collaboration with the account Program Director
Managing and overseeing workload, performance management, staff schedules, personnel management, established Key Performance Indicators (KPI’s) and goal setting for the team. Communicating important information on new and updated processes and procedures to staff
Participating appropriately in client meetings and internal claim process improvement meetings and acting as a liaison between all parties and client stakeholders. Facilitating continuous communication, and continued process improvements as applicable in case management
Being available for occasional escalations outside of normal business hours via an on-call rotation schedule with MLOA leadership
Qualification
Required
Have advanced education and/or designation in healthcare, rehabilitation, or medical field
Work experience of ten + years, training and/or certification in case management, and a minimum of 3 years of claims leadership experience
Show the proven ability to manage both day to day execution and projects to achieve results of business goals and special assignments
Display excellent interpersonal communications skills both written and verbal
Be dedicated to providing high quality customer service, using diplomacy, patient advocacy, and professional competency
Have advanced problem-solving, analytical skills, communication, and client and staff relationship building skills
Have management or supervisory experience and the ability to prioritize and assign work
Display advanced level computer skills using Windows 2000 and Microsoft Office suite of programs including Word, Excel, PowerPoint and Outlook
Hold a Lean Six Sigma Certification and/or formal Operations Strategy training
Be adaptable, flexible, and able to lead/manage the team through change
Effectively navigate organizational complexity, understanding the interdependencies and priorities
Demonstrate emotional intelligence, adaptability for complex challenges, critical thinking, and advanced business expertise
Have experience as an exceptional leader of people who can mentor and build capabilities within a dedicated client team
Demonstrated talent management recruiting and retention strategies
Demonstrate a solid understanding of leveraging technology, tools and data to drive innovation, operational improvements and customer experience
Benefits
Health coverage options
Wellbeing and support programs
Retirement
Vacation and sick leave
Maternity, paternity & adoption leave
Continuing education and training
Several voluntary benefit options
Company
Strada
Strada is a payroll and tech company that offers workforce management with cloud solutions and services for multinational organizations.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Colin Brennan
Chief Executive Officer
Gautam Mekala
Chief Information Officer
Company data provided by crunchbase