QNXT Program Manager

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.

• 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.

• Education: Bachelors 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).

• Masters 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.

• 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.