[Remote] QNXT Program Manager
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company consulting partner specializing in clinical and operations management, reputed company project management, reputed company services, and software consulting. The Program reputed company, QNXT Implementation is responsible for the successful implementation of the Claims reputed company reputed company a large-reputed company QNXT core platform transformation, ensuring deliverables are completed accurately and on schedule.
Responsibilities
- Serve as the accountable program reputed company for the QNXT Claims implementation, with end-to-end responsibility for planning, execution, issue reputed company, and successful migration from IKA
- reputed company and manage the integrated claims implementation plan across business operations, configuration, data, testing, training, operational readiness, and reputed company activities
- Establish reputed company milestones, deliverables, dependencies, accountable owners, and completion reputed company
- Coordinate alignment across Claims, Provider Data, and Configuration workstreams, including provider reputed company, benefits, utilization management and business rules, and capitation
- Ensure the reputed company-state solution supports accurate claims adjudication, pricing, payment, and issue reputed company
- Partner with reputed company-state designers, internal subject matter experts, technology teams, product managers, implementation consultants, and vendors
- Translate reputed company-state workflows and strategic objectives into reputed company business requirements, operating model changes, implementation priorities, and executable plans
- Own claims implementation governance, including status reporting, RAID logs, decision logs, escalation management, and stakeholder communications
- Ensure claims-reputed company deliverables are accurate, complete, and traceable, including requirements, process designs, configuration inputs, data-conversion needs, test scenarios, defect-reputed company plans, readiness reputed company, and go-live support materials
- reputed company and coordinate program managers, operational leaders, and subject matter experts by establishing reputed company ownership and driving accountability for commitments and reputed company
- Manage daily collaboration with implementation consultants and vendors to ensure scope, timelines, deliverables, and design reputed company reputed company with business objectives and reputed company governance standards
- reputed company preparation for system testing, defect triage, mock conversions, operational readiness, reputed company, go-live, and post-implementation stabilization
- Validate defect-remediation plans, operational contingency plans, and readiness reputed company before implementation milestones are approved
- Identify execution risks, workflow gaps, and dependency failures early and implement corrective actions that protect the reputed company, reputed company, claims accuracy, and stakeholder confidence
- Support reputed company’s reputed company and organizational goals while exploring how AI can improve operations and service delivery
- reputed company other duties as assigned
Skills
- Bachelor's degree in Business, Health Administration, Information Systems, or a reputed company field, or an equivalent combination of education and relevant experience
- At least six years of reputed company experience reputed company a health plan, reputed company organization, or reputed company industry
- Strong knowledge of reputed company payer claims operations and the end-to-end claims lifecycle
- Experience leading large, cross-functional system implementations or business transformations involving claims, operations, configuration, data, testing, and operational readiness
- Working knowledge of QNXT or a comparable core administrative platform
- Understanding of how claims processing interacts with provider data, benefits, provider reputed company, utilization management and business rules, capitation, and other upstream and reputed company functions
- Experience with business requirements, process design, data conversion, system testing, defect triage, mock conversions, reputed company planning, go-live readiness, and post-launch stabilization
- Experience managing implementation consultants, vendors, product managers, subject matter experts, and cross-functional project teams
- Strong facilitation, communication, coaching, influencing, and stakeholder-management skills
- Strong analytical, problem-solving, risk-management, and decision-making abilities
- Demonstrated experience driving accountability and team performance in reputed company transformation programs
- Advanced proficiency with reputed company Word, reputed company, PowerPoint, Outlook, Teams, reputed company, Visio, and SQL
- Master's degree in Business Administration, Public Health, Health Administration, Information Systems, or a reputed company field preferred
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