Program Manager - Core Administration Transformation (QNXT)

Contract length: 1 year. Target start date: 3/9/26. Remote – West Coast preferred (Pacific Time Zone availability).

About The Opportunity

Our client, a leader in Healthcare, is looking for a skilled Project Manager – Core Claims System Implementation to join their team for a critical engagement. This project involves leading the end-to-end replacement of their core claims processing platform, transitioning from a legacy system to a modern platform (QNXT). This is a high-impact role that requires a self-motivated professional who can hit the ground running and deliver results quickly.

Responsibilities

• Lead the full lifecycle implementation of the new core claims platform.
• Develop and manage detailed project plans, timelines, milestones, budgets, and risk logs.
• Coordinate and serve as the primary liaison between cross-functional teams, including Claims Operations, Configuration, Enrollment, Provider Data, Finance, and IT Infrastructure & Applications.
• Manage vendor relationships and oversee key project phases such as requirements gathering, system configuration, data migration strategy, UAT coordination, and cutover readiness.
• Establish governance cadence, executive reporting, and ensure regulatory and CMS compliance considerations are incorporated into system design and implementation.

Requirements

• 8+ years of experience in a similar role leading large-scale healthcare systems implementations.
• Deep expertise in direct experience implementing or upgrading core claims platforms (QNXT strongly preferred). This isn't a learning role—you need to be a subject matter expert.
• Demonstrated ability to work autonomously and manage your own time effectively to meet project goals.
• Experience with managing enterprise transformation initiatives and working in matrixed organizations across Business and IT.
• Strong communication skills to provide clear and concise status updates to the project team, including exceptional stakeholder communication at the executive and operational levels.
• Strong understanding of Medicare Advantage plan operations, claims adjudication workflows, and the CMS regulatory environment.
• Proven vendor management experience.

Pay

$90-100/hr.