H

HJ Staffing

·4 days ago

Qnxt program manager

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Location

remote, CA, United States

Commitment

Full Time

Level

Lead / Manager

Required skills

QNXTProgram ManagementClaims AdjudicationPlatform MigrationHealthcare Payer OperationsRAID LogsVendor ManagementSQLMicrosoft VisioData ConversionCutover PlanningRisk ManagementChange ManagementStakeholder ManagementDefect TriageHealthcare Administration

Job Description

We are seeking an QNXT Program Manager to take full accountability for the Claims Workstream within a large-scale QNXT core platform transformation, including migrating from the current IKA platform.

Location: Long Beach, CA (100% Remote)

Schedule: Monday – Friday, 8:00 AM – 5:00 PM (PST)

Start Date: 08/10/2026

End Date: 02/10/2027

In this role, you will lead the end-to-end planning, execution, governance, and delivery of all claims-related implementation activities. You will 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.

Key Responsibilities

  • Program Leadership & Migration: Accountable for end-to-end implementation and issue resolution for the QNXT Claims workstream, driving the complete migration off the IKA platform.
  • Integrated Planning & Governance: 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.
  • Cross-Functional Workstream Alignment: Coordinate alignment across Claims, Provider Data, Benefits, Utilization Management, and Capitation to ensure accurate future-state claims adjudication, pricing, and payment.
  • Vendor & Consultant Management: Direct day-to-day collaboration with external implementation consultants and software vendors to ensure scope, timelines, deliverables, and architecture decisions stay on track.
  • Testing, Cutover & Stabilization: Lead preparations for system testing, defect triage, mock conversions, go-live cutover, and post-implementation stabilization while validating contingency and readiness plans.
  • Risk & Change Management: Proactively identify execution risks, workflow gaps, and dependency issues to safeguard project timelines, claims accuracy, and stakeholder confidence.

Required Qualifications

  • Education: Bachelor’s degree in Business, Health Administration, Information Systems, or a related field (or equivalent combination of education and experience).
  • Experience: Minimum 6 years of related experience within a health plan, managed care, or healthcare organization.
  • Core Platform Expertise: Hands-on experience with QNXT (or a directly comparable core administrative platform) is required.
  • Domain Knowledge: Deep expertise in healthcare payer claims operations and the end-to-end claims lifecycle (adjudication, pricing, payment, and provider/benefit configuration interactions).
  • Transformation Leadership: 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.
  • Technical Proficiency: Advanced skills with Microsoft Office Suite (Word, Excel, PowerPoint, Teams), Visio, Access, and SQL.
  • Work Schedule: Ability to work standard PST business hours (Monday – Friday, 8:00 AM – 5:00 PM PST).

Preferred Qualifications

  • Master’s degree (MBA, MPH, MHA, or MS in Information Systems).
  • Direct experience leading IKA-to-QNXT platform migrations.
  • Experience driving AI-driven operational improvements within healthcare claims environments.

What Will Make You Successful

  • Ability to take end-to-end ownership of a high-stakes, enterprise claims implementation with minimal supervision.
  • Strong consensus-building and coaching skills to align senior leadership, technical teams, consultants, and vendors around common priorities.
  • Comfort navigating fast-paced, complex, and ambiguous transformation environments.
  • Sharp analytical, risk-management, and decision-making skills to resolve blockers before they impact critical path timelines.
  • Exceptional executive-level communication and change-leadership abilities.

Ready to join the team?

Apply now