IT Project Manager -Core Claims Systems Implementation (QNXT)

Title: IT Project Manager (Claims Platform Implementation)
Job Type: Contract
Contract Length: Long-term engagement
Pay Range: $95 / hour
Start Date: ASAP
Location: Remote (West Coast preference)

About the Opportunity:

Our client, a leader in Healthcare and Medicare Advantage, is looking for a skilled IT Project Manager to join their team for a long-term engagement. This project involves leading the technical implementation and enterprise transition of its core claims processing platform from legacy IKA to QNXT. This role will serve as the IT delivery lead, accountable for system architecture alignment, integrations, data conversion, infrastructure readiness, and technical governance. This is a high-visibility, high-impact role that requires a self-motivated professional who can hit the ground running and deliver results quickly.

Key Responsibilities & Deliverables:

This role is focused on the successful completion of specific tasks and deliverables. Your responsibilities will include:

• Lead the full lifecycle technical implementation of QNXT as the enterprise claims platform, including ownership of the integrated IT project plan and technical milestones.
• Oversee Systems & Integration strategy across upstream and downstream systems (enrollment, provider data, finance, reporting, EDI, etc.) and direct data migration strategy.
• Establish Technical Governance & Risk Management structure, release management processes, and drive structured issue resolution across vendors and internal teams.
• Manage Vendor & Partner performance (QNXT vendor and systems integrator), ensuring deliverables meet contractual and technical standards.
• Ensure Compliance & Regulatory Alignment, incorporating CMS and Medicare Advantage regulatory requirements into system design and partnering with compliance teams for validation.

Required Skills & Experience:

We are looking for someone with a proven track record of successful contract engagements. The ideal candidate will have:

• 8+ years of IT Project or Program Management experience leading large-scale healthcare systems implementations.
• Deep expertise in implementing or upgrading core claims platforms (QNXT strongly preferred). This includes a strong understanding of claims adjudication systems/workflows, Medicare Advantage operations, and CMS regulatory/reporting requirements. 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 complex, enterprise-wide technology transformations, and strong knowledge of SDLC, testing methodologies, and structured governance frameworks.
• Strong communication skills to provide clear and concise status updates to the project team and provide executive-level reporting on technical progress.

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