Program Manager

Job not on LinkedIn

🔥 0 minutes ago

🏄 California – Remote

🏄 California – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Program Manager

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

HJ Staffing

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2016

🤝 B2B

🎯 Recruiter

👥 HR Tech

B2B • Recruitment • HR Tech

HJ Staffing is a premier staffing agency dedicated to providing tailored workforce solutions for businesses across various industries. With a focus on delivering exceptional human resources support, HJ Staffing connects leading companies with outstanding talent through temporary staffing, direct placement, and human resource consulting. The company serves clients in multiple states including Texas, Louisiana, Delaware, and California, asserting its commitment to a personalized approach and superior customer service in every client relationship.

📋 Description

• Lead the end-to-end planning, execution, governance, and delivery of all claims-related implementation activities • Collaborate closely with product managers and leaders supporting Provider Data, Configuration (provider contracts, benefits, utilization management, business rules), and Capitation to ensure a seamless migration, precise claims adjudication, and operational readiness for go-live • Accountable for end-to-end implementation and issue resolution for the QNXT Claims workstream, driving the complete migration off the IKA platform • Manage the claims implementation plan across operations, configuration, testing, data conversion, training, cutover, and post-go-live stabilization • Maintain RAID logs, decision logs, and status reporting • Coordinate alignment across Claims, Provider Data, Benefits, Utilization Management, and Capitation to ensure accurate future-state claims adjudication, pricing, and payment • Direct day-to-day collaboration with external implementation consultants and software vendors to ensure scope, timelines, deliverables, and architecture decisions stay on track • Lead preparations for system testing, defect triage, mock conversions, go-live cutover, and post-implementation stabilization while validating contingency and readiness plans • Proactively identify execution risks, workflow gaps, and dependency issues to safeguard project timelines, claims accuracy, and stakeholder confidence

🎯 Requirements

• Bachelor’s degree in Business, Health Administration, Information Systems, or a related field (or equivalent combination of education and experience) • Minimum 6 years of related experience within a health plan, managed care, or healthcare organization • Hands-on experience with QNXT (or a directly comparable core administrative platform) is required • Deep expertise in healthcare payer claims operations and the end-to-end claims lifecycle (adjudication, pricing, payment, and provider/benefit configuration interactions) • Proven experience leading large, cross-functional system implementations or platform migrations involving data conversion, system testing, defect triage, mock conversions, cutover planning, and go-live stabilization • Advanced skills with Microsoft Office Suite (Word, Excel, PowerPoint, Teams), Visio, Access, and SQL • Ability to work standard PST business hours (Monday – Friday, 8:00 AM – 5:00 PM PST)

🏖️ Benefits

• Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options