The Clinical Operations Manager will manage the activities of a team of clinical case managers supporting STD, FMLA and LTD. Also, the Clinical Operations manager will provide oversight and asst in training of all clinical protocols and best practices used by our absence management clinical staff, including Registered Nurses, and Vocational Rehabilitation Counselors. The Clinical Operations Manager will serve as a Senior Clinical reviewer for highly complex, high-profile escalated claims.
You will
Manage a team of clinical case managers (CCM’s)
Lead, motivate, and develop assigned clinical case manager staff
Assess and monitor clinical case manager’s workload capacity and efficiency
Assess and measure staff performance and set appropriate goals
Perform mid-year and annual performance evaluations, communicating expectations, goals, deadlines and team results
Monitor and control personnel issues of clinical claim managers and work directly with Human Resources as needed




Coordinate with other clinical operations managers to provider clinical case management support across Alight’s book of business.
Conduct clinical audits and provide feedback and mentoring, coordinate with clinical leaders on corrective actions as applicable
Support operations claims teams by monitoring and resolving escalated customer complaints related to clinical issues
Participate in the reinforcement of return-to-work best practice protocols and workflows
Occasionally assist with overflow of clinical reviews upon request of manager
Perform side by side listening/shadowing and coaching with team members to assist in further development of clinical staff.
Collaborate with senior clinical reviewer for highly complex high profile disability claims and/or escalated claims.
Conduct regular clinical round tables to determine level of functional impairment based on knowledge of medical signs and symptoms and the employer’s essential job functions and reinforce methodology of reviewing claims based on best

📌 Clinical Operations Manager (Gurugram)
🏢 Alight Solutions
📍 Gurugram