Job Title : Program Managers with Healthcare Payer
Location : Remote
Duration : 12 Months
Job Description :
Roles and Responsibilities:
Experienced Delivery Leads / Program Managers to lead execution of a large portfolio of state-mandated regulatory and compliance initiatives across Medicaid and healthcare payer operations. This role will be responsible for coordinating multiple concurrent workstreams supporting regulatory changes, backlog remediation, and 2027 implementation readiness across Claims, Eligibility, Regulatory Reporting, Provider, Data, and Integration platforms. The Delivery Lead will serve as the primary orchestration point across business, regulatory, architecture, engineering, testing, data, operations, and vendor teams, ensuring successful and compliant delivery of regulatory commitments while managing risks, dependencies, capacity, schedules, and stakeholder communications.
Key Responsibilities
Required Qualifications
- Bachelor's degree in Business, Information Systems, Healthcare Administration, Engineering, or related field.
- 15+ years of program, project, or delivery management experience.
- 10+ years leading large-scale healthcare payer transformation or regulatory programs.
- Demonstrated experience managing multiple parallel delivery teams and workstreams.
- Experience delivering regulatory and compliance initiatives within Medicaid, Medicare, or Commercial healthcare environments.
- Strong understanding of:
- Program and portfolio management
- SDLC methodologies
- Agile and SAFe frameworks
- Risk and dependency management
- Executive stakeholder management
Preferred Qualifications
- Experience managing state Medicaid regulatory implementations.
- Knowledge of CMS regulations and Medicaid managed care operations.
- Experience with healthcare payer platforms including:
- Facets
- QNXT
- HealthRules
- Custom claims and eligibility systems
- Experience coordinating complex data and integration initiatives involving:
- EDI transactions
- APIs
- Data warehouse platforms
- Regulatory reporting solutions
- PMP, PgMP, PMI-ACP, SAFe Program Consultant (SPC), or SAFe Release Train Engineer (RTE) certification preferred.
Program Management Tools
- Azure DevOps
- Jira
- Confluence
- Microsoft Project
- Smartsheet
- Power BI
- Excel
Core Competencies
- Portfolio Delivery Management
- Regulatory Program Leadership
- Dependency Management
- Risk Management
- Financial & Capacity Planning
- Executive Communication
- Vendor Management
- Release Management
- Stakeholder Alignment
- Organizational Change Management
Thanks & Regards
Bhavanesh Eamani
Lead Technical Recruiter
PH : 972 440 0073
Agile Enterprise Solutions Inc.
2591 Dallas Parkway Suite 300 Frisco, TX 75034
Email: bhavanesh@aesincus.com Website: www.aesincus.com
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