Manager, Appeals-Alight Leave Solutions

Appeals Manager

The Appeals Manager is responsible for leading the day-to-day operations of Alight's Disability and Absence Management Appeals team. This role oversees the administration and quality of appeals across Short-Term Disability and Long-Term Disability (LTD) programs. The Appeals Manager provides leadership, coaching, and operational oversight to ensure exceptional client service, regulatory compliance, quality outcomes, and team performance.

Responsibilities

• 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 or 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.