QNXT Program Manager
New
H
HJ StaffingHealth Plan / Managed Care
Long Beach, CA (100% Remote), Monday – Friday, 8:00 AM – 5:00 PM (PST)Full-TimeManager
Salary not disclosed
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Job Details
- Experience
- Minimum 6 years
- Required Skills
- Project ManagementSQLMicrosoft Office
Requirements
- Bachelor’s degree in Business, Health Administration, Information Systems, or a related field.
- 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.
- 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).
Responsibilities
- 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.
- 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.
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