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 connecting purpose with impact. Alight empowers clients to build a healthier and more financially secure workforce by unifying the benefits ecosystem across health, wealth, wellbeing, navigation, and absence 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 vision coverages starting Day 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 can be your 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” 6 years in a row.

Great Place to Work

Thanks to the work of every colleague, Alight has received multiple awards of recognition including “Great Place to Work” for the past 7 years and Fortune’s “Best Companies to Work For.” To learn more about our company culture and awards Click Here.

If you, Champion People, seek to Grow with Purpose, and embody the meaning of Be Alight – We invite you to join our team! Learn more at careers.alight.com.

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 employer‑sponsored programs to support informed care decisions
  • Completing cost estimates and communicating out‑of‑pocket responsibility, claim results, denials, appeals, and escalation outcomes with accurate expectations and timelines
  • Explaining prescription formulary options, prescription alternatives, prior authorization outcomes, and available cost‑saving opportunities
  • Proactively identifying unmet clinical needs and owning the connection to appropriate clinical support and care resources
  • Connecting 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 be made an 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. Please be aware that Alight is a camera-on culture and may require occasional travel to one of our physical office locations.

Our commitment to 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 thrive. Join us in building a brighter, more inclusive future.

As part of this commitment, Alight will ensure that persons with disabilities are provided reasonable accommodations for the hiring process. If reasonable accommodation is needed, please contact alightcareers@alight.com.

Equal Opportunity Policy Statement

Alight is an Equal Employment Opportunity employer and does not 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 or veteran status, sexual orientation, gender, gender identity or expression, genetic information, or any other legally protected characteristics or conduct covered by federal, state, or local law. In addition, we take affirmative action to employ disabled persons, disabled veterans, and other covered veterans.

Alight provides reasonable accommodations to the known limitations of otherwise qualified employees and applicants for employment with disabilities and sincerely held religious beliefs, practices and observances, unless doing so would result in undue hardship. Applicants for employment may request reasonable accommodations/modifications by contacting their recruiter.

Authorization to work in the Employing Country

Applicants for employment in the country in which they are applying (Employing Country) must have work authorization that does not, now or in the future, require sponsorship of a visa for employment authorization in the Employing Country and with Alight.

Note, this job description does not restrict management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.

We offer you a competitive total rewards package, continuing education & training, and tremendous potential with a growing worldwide organization.

Salary Pay Range

Minimum :

50,000.00 USD

Maximum :

50,000.00 USD

Pay Transparency Statement: Alight considers a variety of factors in determining whether to extend an offer of employment and in setting the appropriate compensation level, including, but not limited to, a candidate’s experience, education, certification/credentials, market data, internal equity, and geography. Alight makes these decisions on an individualized, non-discriminatory basis. Bonus and/or incentive eligibility are determined by role and level. Alight also offers a comprehensive benefits package; for specific details on our benefits package, please visit: Wellbeing and Benefits Selector Page - Alight

DISCLAIMER:

Nothing in this job description restricts management's right to assign or reassign duties and responsibilities of this job to other entities; including but not limited to subsidiaries, partners, or purchasers of Alight business units.

Alight Solutions provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, creed, sex, sexual orientation, gender identity, national origin, age, disability, genetic information, pregnancy, childbirth or related medical condition, veteran, marital, parental, citizenship, or domestic partner status, or any other status protected by applicable national, federal, state or local law. Alight Solutions is committed to a diverse workforce and is an affirmative action employer.

Originally posted on Himalayas