Health Pro Consultant - US Virtual

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."We are passionate about connectingpurposewith impact.Alightempowersclientsto builda healthierandmorefinancially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing,navigation, andabsence management.

Our Benefits

With a comprehensive total rewards package, Alight offers programs and plans that support your mind, body, wallet, and life. Benefits include health, dental and visioncoveragesstartingDay One. Additionally, Alight colleagues enjoy wellbeing programs, retirement plans with contribution matching, generous time off, parental leave, continuing education, and career growth opportunities - all within a thriving global organization.

Flexible Working

So that you canbeyour best at work and home, we consider flexible working arrangements wherever possible. Alight has been a leader in the flexible workspace and "Top 100 Company for Remote Jobs"6yearsin a row.

Great PlacetoWork

Thanks to the work of everycolleague, Alight has received multiple awards of recognition including"GreatPlace to Work" for the past 7 years and Fortune's "Best Companies to Work For." To learn more about our company culture and awardsClick Here.

If you,Champion People,seekto Grow with Purpose,and embody the meaning of Be Alight- We invite you to join our team!Learn more atcareers.alight.com.

We Offer You

A competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization:

A full Benefits Package, starting on your first day of employment

Health, Dental, Vision, Life Insurance and more.

A 401k plan that includes a corporate match.

Paid Time Off

10 paid holidays per calendar year (8 fixed and 2 floating) 6 paid wellness days

Career Development & Growth:

We provide ongoing training, coaching and development specific to the Health Pro role and reward continuous improvement while encouraging you to own your own development.

Alight provides a collaborative environment that embodies and holds the following stated values close to heart: Champion People, Grow with Purpose, and Be Alight.

As a Health Pro, you can expect the following:

When you start, you will receive extensive health care and case management training to ensure you are equipped to support members on complicated healthcare matters

Your primary responsibility is to be an advocate for members requiring guidance across the health benefits environment by helping them navigate questions about their benefits, identify the highest quality and cost-effective providers, understand benefit claims, and be an advocate for the employee across the health ecosystem. You will gather a full understanding of the members' needs and own the resolution of the customer's request. Activities include, but are not limited to the following:

Gathering information about the reason the customer is seeking support or care

Educating members on benefit programs provided by clients

Translating complex benefit details (e.g., deductibles, coverage limits, prior authorizations) into clear, actionable guidance members can understand and use

Delivering provider recommendations, referral guidance, and connections to clinical or employersponsored programs to support informed care decisions

Completing cost estimates and communicating outofpocket responsibility, claim results, denials, appeals, and escalation outcomes with accurate expectations and timelines

Explaining prescription formulary options, prescription alternatives, prior authorization outcomes, and available costsaving opportunities

Proactively identifying unmet clinical needs and owning the connection to appropriate clinical support and care resourcesConnecting members to company sponsored health and benefits programs for specialized care

Providing proactive, timely updates via phone and digital channels and ensuring members feel supported through full case resolution

Navigating medical bill review results, including identified errors and savings achieved, and translating findings into clear, actionable guidance for members

Drafting carrier and client appeals for healthcare services

Coordinating records transfers and authorization requests that require pre-service approval

This work involves leveraging developed methodologies, navigating internal tools and applications, as well as making external phone calls, partnering with carriers and providers (via email and phone outreach) to resolve member needs. The scope of work is dedicated at the employee level and you will be responsible for working employee cases through resolution.

You will interact with members through incoming calls, emails, and messaging system interactions. You will be responsible for utilizing exceptional communication, empathy, and problem solving skills to understand and solve complex customer needs, resulting in a better experience for the employee's entire healthcare journey.

Required Qualifications

Minimum of 2 years of experience in a medical assistant/medical support role, or 3 years of experience working in a customer-facing role within the healthcare industry

Ability to work effectively in a remote team environment

Strong listening, reasoning, and analytical skills - ability to listen to members' needs and dig deeper to understand the root cause of their concern with empathy.

Exceptional verbal and written communication skills - can convey complex concepts, both verbally and in writing, for members that are not benefits experts

Strong ability and desire to learn continually in a changing environment

Exceptional critical thinking and problem-solving skills

Ability to efficiently organize work activities to meet deadlines

Passion to provide the highest level of client satisfaction

Ability to receive and immediately apply constructive feedback

Ability to develop effective rapport with clients based on empathy and trust

Proficiency in MS Office suite

Application and Interview

By applying for a position with Alight, you understand that, should you bemadean offer, it will be contingent on your undergoing and successfully completing a background check consistent with Alight's employment policies. Background checks may include some or all the following based on the nature of the position: SSN/SIN validation, education verification, employment verification, and criminal check, search against global sanctions and government watch lists, credit check, and/or drug test. You will be notified during the hiring process which checks are required by the position.

Alight requires all virtual interviews to be conducted on video.

Our commitment to Inclusion

Wecelebrate 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 thrive. Join us in building a brighter, more inclusive future.

As part of this commitment, Alight will ensure thatpersonswith disabilities areprovidedreasonableaccommodationsfor the hiring process.If reasonable accommodation is needed, please [email protected].

Equal OpportunityPolicy Statement

Alight is an Equal Employment Opportunity employerand doesnot 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