Project Manager – Product & Portfolio (TPA – Healthcare / Benefits Administration)
This a Full Remote job, the offer is available from: New York (USA)
Job Title: Project Manager – Product & Portfolio (TPA – Healthcare / Benefits Administration)
Location: Remote
Time Zone: EST with flexibility
Type: Contract (6 months) with possibility of extension or conversion (must be willing to convert to perm)
Rate: 70-80 Depending on experience
Position Overview
We are seeking an experienced Project Manager with a strong background in Third-Party Administration (TPA) to lead strategic and operational initiatives. This role focuses on project delivery across medical management, provider operations, eligibility, customer care, and claims, while supporting new client implementations and ongoing production management for existing clients.
The ideal candidate brings deep healthcare payer and TPA experience, excels in managing cross-functional teams, and is confident working across business and IT stakeholders. This individual must be comfortable navigating complex healthcare environments, including regulatory requirements and upcoming 2026 mandates, while driving successful client onboarding and operational excellence.
Key Responsibilities
• Lead end-to-end project management for TPA initiatives across medical management, provider, eligibility, claims, and customer care
• Manage implementation and onboarding of new self-funded clients, including planning, execution, testing, and go-live
• Oversee production management for existing clients, ensuring service delivery, issue resolution, and continuous improvement
• Partner with business, operations, IT, vendors, and external stakeholders to define requirements and deliver solutions
• Develop and manage detailed project plans, including timelines, milestones, budgets, resource allocation, risks, and dependencies
• Proactively manage RAID (Risks, Issues, Actions, Decisions) and drive mitigation strategies
• Ensure compliance with healthcare regulations and readiness for 2026 mandates
• Drive process improvements and operational efficiencies across TPA and payer functions
• Communicate project status, risks, and outcomes clearly to leadership and stakeholders
• Facilitate meetings, manage escalations, and ensure alignment across cross-functional teams
• Support coordination across upstream and downstream systems including enrollment vendors, claims platforms, portals, and reporting systems
Required Qualifications
• 6+ years of program/project management experience within healthcare payer or TPA environments, with a strong focus on client and product implementation
• 4+ years of functional healthcare payer experience working across business and IT solutions for self-funded client implementations
• Hands-on experience across key domains including:
• Enrollment / Eligibility (upstream & downstream vendor integrations)
• Benefit Administration (new client setup)
• Claims Administration (processing)
• Provider and Member Services / Portals
• Finance (billing, invoicing, reporting)
• Strong experience with TPA (Third-Party Administration) environments
• Proven ability to lead new client onboarding and implementation projects, as well as production support for existing clients
• Solid understanding of healthcare operations, data flows, and regulatory requirements (including upcoming mandates)
• Excellent communication skills with the ability to engage both technical and business stakeholders
• Strong organizational, problem-solving, and leadership skills
• Ability to manage multiple projects in a fast-paced, complex environment
Preferred Qualifications
• Experience supporting multi-employer / Taft-Hartley plans
• PMP, Scrum, or other project management certification
• Experience with Agile, Waterfall, or hybrid delivery methodologies
• Experience working with healthcare systems, claims platforms, or benefits administration platforms
This offer from "Quantix, Inc." has been enriched by Jobgether.com and got a 72% flex score.
Apply tot his job
Apply To this Job
Job Title: Project Manager – Product & Portfolio (TPA – Healthcare / Benefits Administration)
Location: Remote
Time Zone: EST with flexibility
Type: Contract (6 months) with possibility of extension or conversion (must be willing to convert to perm)
Rate: 70-80 Depending on experience
Position Overview
We are seeking an experienced Project Manager with a strong background in Third-Party Administration (TPA) to lead strategic and operational initiatives. This role focuses on project delivery across medical management, provider operations, eligibility, customer care, and claims, while supporting new client implementations and ongoing production management for existing clients.
The ideal candidate brings deep healthcare payer and TPA experience, excels in managing cross-functional teams, and is confident working across business and IT stakeholders. This individual must be comfortable navigating complex healthcare environments, including regulatory requirements and upcoming 2026 mandates, while driving successful client onboarding and operational excellence.
Key Responsibilities
• Lead end-to-end project management for TPA initiatives across medical management, provider, eligibility, claims, and customer care
• Manage implementation and onboarding of new self-funded clients, including planning, execution, testing, and go-live
• Oversee production management for existing clients, ensuring service delivery, issue resolution, and continuous improvement
• Partner with business, operations, IT, vendors, and external stakeholders to define requirements and deliver solutions
• Develop and manage detailed project plans, including timelines, milestones, budgets, resource allocation, risks, and dependencies
• Proactively manage RAID (Risks, Issues, Actions, Decisions) and drive mitigation strategies
• Ensure compliance with healthcare regulations and readiness for 2026 mandates
• Drive process improvements and operational efficiencies across TPA and payer functions
• Communicate project status, risks, and outcomes clearly to leadership and stakeholders
• Facilitate meetings, manage escalations, and ensure alignment across cross-functional teams
• Support coordination across upstream and downstream systems including enrollment vendors, claims platforms, portals, and reporting systems
Required Qualifications
• 6+ years of program/project management experience within healthcare payer or TPA environments, with a strong focus on client and product implementation
• 4+ years of functional healthcare payer experience working across business and IT solutions for self-funded client implementations
• Hands-on experience across key domains including:
• Enrollment / Eligibility (upstream & downstream vendor integrations)
• Benefit Administration (new client setup)
• Claims Administration (processing)
• Provider and Member Services / Portals
• Finance (billing, invoicing, reporting)
• Strong experience with TPA (Third-Party Administration) environments
• Proven ability to lead new client onboarding and implementation projects, as well as production support for existing clients
• Solid understanding of healthcare operations, data flows, and regulatory requirements (including upcoming mandates)
• Excellent communication skills with the ability to engage both technical and business stakeholders
• Strong organizational, problem-solving, and leadership skills
• Ability to manage multiple projects in a fast-paced, complex environment
Preferred Qualifications
• Experience supporting multi-employer / Taft-Hartley plans
• PMP, Scrum, or other project management certification
• Experience with Agile, Waterfall, or hybrid delivery methodologies
• Experience working with healthcare systems, claims platforms, or benefits administration platforms
This offer from "Quantix, Inc." has been enriched by Jobgether.com and got a 72% flex score.
Apply tot his job
Apply To this Job