§ Direct and oversee the quality function for claims operations
§ Work with the Operations Leader in establishing standardized policies and procedures for the administration of insurance claims related to leave absence
§ Ensure compliance with industry standards, regulations, and best practices.
Quality Assurance
§ Develop and implement quality assurance processes to enhance claims handling efficiency and accuracy.
§ Monitor claims processing, review outcomes, and identify areas for improvement.
§ Collaborate with cross-functional teams to address quality gaps.
Performance Metrics
§ Define and track key performance indicators (KPIs) related to claims quality, turnaround time, and customer satisfaction.
§ Analyze data to drive continuous improvement initiatives.
Staff Development:
§ Provide expert guidance and consultation to staff on complex claims scenarios.
§ Foster a culture of continuous learning and professional growth.
Stakeholder Communication
§ Collaborate with senior management, underwriters, and other departments to align quality goals.
§ Communicate quality-related updates and initiatives to internal and external stakeholders.
Risk Management:
§ Mitigate risks associated with claims processing errors, fraud, and non-compliance.
§ Implement preventive measures and corrective actions.
Budgeting and Resource Allocation:
§ Develop and manage budgets for quality assurance programs.
§ Allocate resources effectively to achieve quality objectives.
Process Optimization:
§ Identify bottlenecks and streamline claims workflows.
§ Implement technology solutions to enhance efficiency through automation.
Continuous Improvement:
§ Stay informed about industry trends, emerging technologies, and regulatory changes.
§ Drive innovation and adapt best practices to improve claims operations.
Requirements
**Education**:
Masters/Bachelor's degree in a relevant field (e.g., Business Administration, Insurance, Quality Management).
Master Black Belt certification is a Must Have.
**Experience**:
Minimum 15 years of managerial experience in claims operations or quality management.
Deep understanding of claims processes, insurance policies, and risk assessment.
Skills:
Strong analytical skills and attention to detail.
Excellent communication and leadership abilities.
Proficiency in using claims management software and data analytics tools.
MBB Certification in quality management (e.g., Six Sigma, Lean) is a must have.
Benefits
Our commitment to Diversity and InclusionAlight is committed to diversity, equity, and inclusion. We celebrate differences and believe in fostering an environment where everyone feels valued, respected, and supported. We know that diverse teams are stronger, more innovative, and more successful.At Alight, we welcome and embrace all individuals, regardless of their background, and are dedicated to creating a culture that enables every employee to thrHealth insurancePaid time offEquity / stock options
Additional Information
Our story
At Alight, we believe a company's success starts with its people. At our core, we Champion People, help our colleagues Grow with Purpose and true to our name we encourage colleagues to "Be Alight."
Our Values:
Champion People - be empathetic and help create a place where everyone belongs.
Grow with purpose - Be inspired by our higher calling of improving lives.
Be Alight - act with integrity, be real and empower others.
It's why we're so driven to connect passion with purpose. Our team's expertise in human insights and cloud technology gives companies and employees around the world the ability to power confident decisions, for life.
With a comprehensive total rewards package, continuing education and training, and tremendous potential with a growing global organization, Alight is the perfect place to put your passion to work.
Join our team if you Champion People, want to Grow with Purpose through acting with integrity and if you embody the meaning of Be Alight.
Learn more at careers.alight.com.
Alight · Hr-gurgaon-dlf Cyber Greens, IN