Program Lead, QNXT Implementation - SCAN Temp

The Job

The Program Lead, QNXT Implementation - SCAN Temp is the accountable leader for successful implementation of the Claims workstream within the QNXT core platform transformation, including migration from the current IKA platform. This role directs end-to-end planning, execution, governance, and delivery across claims-related workstreams and coordinates closely with supporting product managers for Claims, Provider Data, and Configuration (including provider contracts, benefits, UM/business rules, and capitation), future state design, internal subject matter experts, and external consultants.

This role is responsible for ensuring all deliverables are completed with quality and on schedule, risks and dependencies are actively managed, teams are coached and aligned, and the organization is operationally ready for testing, cutover, and go-live.

Qualifications

• Bachelor’s degree or equivalent combination of education and experience - Business, Health Administration, Information Systems, or related fields.
• Master’s degree (preferred) - MBA, MPH, MS in Health Administration, Information Systems, or related field.
• Minimum 6 years related experience with in the health plan, healthcare, or related industry.
• Strong knowledge of healthcare payer claims operations, end-to-end claims lifecycle, and business processes required to support accurate adjudication, pricing, payment, and issue resolution.
• Experience leading large, cross-functional system implementations or business transformations involving claims, operations, configuration, data, testing, and operational readiness.
• Working knowledge of QNXT or comparable core administrative platforms, including the relationship between claims processing and upstream/downstream functions such as provider data, benefits, contracts, UM/business rules, and capitation.
• Ability to build and manage integrated workplans, deliverables, RAID logs, decision logs, and governance routines in a complex program environment.
• Ability to translate strategy and future state design into clear business requirements, implementation priorities, accountable owners, and executable plans.
• Strong facilitation, communication, and influencing skills, with the ability to align senior leaders, SMEs, operational teams, and consultants around decisions, priorities, and timelines.
• Demonstrated ability to coach teams, drive accountability, and elevate performance in fast-paced, ambiguous, and high-stakes transformation environments.
• Strong analytical and problem-solving skills, including the ability to assess risks, surface tradeoffs, resolve blockers, and make sound decisions with incomplete information.
• Experience supporting implementation testing, defect triage, operational readiness, cutover planning, and go-live stabilization for major platform transitions.
• Ability to balance strategic transformation goals with day-to-day operational realities to deliver a stable, controlled, and business-ready migration from IKA to QNXT.
• Program leadership and accountability.
• Strategic planning and execution discipline.
• Cross-functional collaboration and influence.
• Executive communication and stakeholder management.
• Coaching, team leadership, and talent development.
• Risk management and decision making.
• Change leadership and organizational readiness.
• Consultant and vendor management.
• Operational excellence and results orientation.

What's in it for you?

• Base Wage Range: $51.06 - $73.90 hourly
• Work Mode: Mostly Remote
• Medical Benefits
• Paid Sick Time
• Excellent 401(k) Retirement Saving Plan
• Robust employee recognition program
• An opportunity to become part of a team that makes a difference to our members and our community every day!