Job Summary:
We are seeking an experienced and strategic Senior Program Manager to lead a major transformation initiative involving the upgrade, migration, and conversion of core claims systems. The ideal candidate will have a strong background in overseeing large-scale technology transformations within the healthcare payer industry, specifically with experience in migrating platforms and transitioning to a Business Process as a Service (BPaaS) model.
Key Responsibilities:
- Program Leadership: Lead the end-to-end execution of a core claims system transformation initiative, including system upgrades, data migrations, and platform conversions, ensuring alignment with business objectives and strategic goals.
- Stakeholder Management: Collaborate with cross-functional teams, including IT, operations, finance, and external vendors, to ensure seamless integration and alignment of the transformation project with overall business processes.
- Risk Management: Identify, assess, and mitigate risks throughout the program lifecycle, ensuring that potential issues are proactively managed and resolved.
- Change Management: Develop and implement change management strategies to facilitate the transition to new systems and processes, ensuring minimal disruption to business operations.
- BPaaS Transition: Drive the transition to a Business Process as a Service (BPaaS) model, ensuring that the new platform supports this model and aligns with the organization's long-term strategic vision.
- Budget & Resource Management: Oversee program budgets, ensuring that financial resources are effectively allocated and that the program remains on track financially. Manage program resources, including staff and external consultants, to ensure the successful delivery of the project.
- Performance Tracking & Reporting: Monitor program performance against key milestones and deliverables, providing regular updates to senior leadership and other stakeholders. Ensure that the program is delivered on time, within scope, and within budget.
- Quality Assurance: Ensure that all aspects of the transformation meet the highest standards of quality, including system performance, data integrity, and compliance with regulatory requirements.
Qualifications:
- Education: Bachelor's degree in Information Technology, Business Administration, or a related field. A Master's degree or relevant certifications (e.g., PMP, PgMP) is a plus.
- Minimum of 10 years of experience in program management, with a strong focus on large-scale IT transformation projects
- Documented experience in overseeing core claims system upgrades, migrations, and conversions within the healthcare payer industry and priority given to candidates with major carrier or Client experience.
- Expertise with adjudication platforms including Cognizant's Facets product, Healthedge's HealthRules Payer platform.
- Proven experience in transitioning organizations to a BPaaS model.
- Technical Skills: In-depth understanding of core claims processing systems and related technologies. Strong knowledge of project management methodologies, tools, and techniques. Familiarity with cloud-based solutions and data migration strategies.
- Leadership Skills: Exceptional leadership and interpersonal skills, with the ability to lead cross-functional teams and influence senior stakeholders. Strong problem-solving and decision-making abilities, with a strategic mindset.
- Communication Skills: Excellent verbal and written communication skills, with the ability to clearly articulate complex technical concepts to non-technical stakeholders. Experience in preparing and delivering presentations to senior leadership and other key stakeholders.