IT Project Manager (Claims Platform Implementation) - Remote (West Coast preference)

V-Soft Consulting Group, Inc. is currently hiring an IT Project Manager for Claims Platform Implementation. The role involves leading the full lifecycle technical implementation of QNXT as the enterprise claims platform and managing vendor performance to ensure compliance with regulatory standards.

Responsibilities:

• Lead the full lifecycle technical implementation of QNXT as the enterprise claims platform, including ownership of the integrated IT project plan and technical milestones
• Oversee Systems & Integration strategy across upstream and downstream systems (enrollment, provider data, finance, reporting, EDI, etc.) and direct data migration strategy
• Establish Technical Governance & Risk Management structure, release management processes, and drive structured issue resolution across vendors and internal teams
• Manage Vendor & Partner performance (QNXT vendor and systems integrator), ensuring deliverables meet contractual and technical standards

Requirements:

• 8+ years of IT Project or Program Management experience leading large-scale healthcare systems implementations
• Deep expertise in implementing or upgrading core claims platforms (QNXT strongly preferred)
• Strong understanding of claims adjudication systems/workflows, Medicare Advantage operations, and CMS regulatory/reporting requirements
• Demonstrated ability to work autonomously and manage your own time effectively to meet project goals
• Experience with managing complex, enterprise-wide technology transformations
• Strong knowledge of SDLC, testing methodologies, and structured governance frameworks
• Ensure Compliance & Regulatory Alignment, incorporating CMS and Medicare Advantage regulatory requirements into system design
• Strong communication skills to provide clear and concise status updates to the project team and provide executive-level reporting on technical progress