Technical Project Manager - Healthcare (Claims, Benefits & Membership)

Job Title: Technical Project Manager Healthcare (Claims, Benefits & Membership)

100% Remote

Role Summary

We are seeking an experienced Technical Project Manager to lead enterprise healthcare modernization initiatives. The ideal candidate will have deep healthcare payer experience and a proven track record of managing large-scale system implementations involving claims, benefits, membership, and data modernization. Experience with QNXT is highly preferred.

Key Responsibilities

Lead end-to-end delivery of large healthcare technology modernization projects.

Manage system implementations, upgrades, migrations, and platform modernization initiatives.

Drive projects involving healthcare claims, benefits, eligibility, enrollment, and membership.

Coordinate cross-functional teams including business, technology, data, QA, infrastructure, and vendor partners.

Manage project scope, schedule, budget, risks, issues, and dependencies.

Lead Agile and Waterfall project execution and provide executive-level status reporting.

Partner with business stakeholders to translate requirements into technical solutions.

Oversee data migration, system integration, and implementation activities.

Ensure projects are delivered on time, within scope, and meet business objectives.

Required Qualifications

10+ years of Project/Program Management experience.

Strong Healthcare Payer experience.

Hands-on experience delivering projects involving:

Claims

Benefits Administration

Membership

Eligibility & Enrollment

Experience leading large enterprise system implementation or modernization projects.

Strong understanding of healthcare data, integrations, and data migration.

Experience working with vendors and executive stakeholders.

Strong Agile/Scrum and SDLC experience.

Experience with QNXT.

Preferred Qualifications

Experience with healthcare data warehouses or cloud modernization.

Knowledge of EDI (834, 837, 835, 270/271).

PMP or Scrum certification.