Consulting Manager, Healthcare Project Manager

Cognizant is a global consulting company helping clients reimagine their businesses through industry and technology advisory services. The Consulting Manager will lead assessments of Long-Term Services and Supports operations, analyze healthcare platforms and workflows, and develop recommendations, remediation roadmaps, and transformation strategies.

Responsibilities:

• Lead end-to-end assessment and documentation of LTSS business processes across authorization, claims, provider, member, and financial workflows
• Analyze interactions between Pega, QNXT, and related healthcare platforms to identify process, integration, and data flow gaps
• Evaluate authorization-to-claims transaction integrity, data mappings, and operational controls to identify root causes of processing issues and financial leakage
• Facilitate stakeholder workshops, discovery sessions, and executive presentations to align business and technology teams on findings and recommendations
• Develop actionable remediation roadmaps, business cases, risk assessments, and transformation strategies that improve operational performance and reduce business risk

Requirements:

• Bachelor's degree or equivalent professional experience in Healthcare Administration, Information Systems, Business, or a related field
• 8+ years of experience in healthcare consulting, business transformation, program management, or healthcare operations
• Strong experience with QNXT and healthcare payer platforms, including claims, benefits, enrollments, and authorization workflows
• Experience working with Pega-based healthcare workflows, care management, or authorization management processes
• Proven expertise in healthcare process analysis, stakeholder management, business requirements, and current-state/future-state process mapping
• Experience conducting system integration reviews, data lineage assessments, reconciliation analysis, and business impact evaluations
• Strong communication and executive presentation skills with the ability to influence stakeholders across business and technology organizations
• Experience creating executive-level deliverables, recommendations, remediation roadmaps, and transformation strategies
• Experience supporting Molina Healthcare or other Medicaid and LTSS-focused healthcare organizations
• Knowledge of healthcare claims processing, financial workflows, payment integrity, and leakage analysis
• Experience leading enterprise assessments involving interoperability, data governance, and technology modernization initiatives
• Familiarity with healthcare regulatory requirements, managed care operations, and value-based care environments
• Experience with business architecture, process mining, workflow optimization, or healthcare transformation consulting engagements