Project Manager (Healthcare Claims Domain)

Job Description – Project Manager (Healthcare Claims Domain)

Position: Project Manager (PM)
Domain: Healthcare – Claims
Experience: 10+ Years
Location: Hartford, CT

Job Summary

We are looking for an experienced Project Manager with strong Healthcare Claims domain expertise to lead and manage large-scale enterprise projects. The ideal candidate should have proven experience managing projects with budgets exceeding $3M and successfully delivering complex healthcare initiatives involving claims processing, payer systems, and digital transformation programs.

Key Responsibilities

• Lead end-to-end project delivery for Healthcare Claims initiatives.
• Manage large-scale projects/programs with budgets of $3M or more.
• Coordinate with business stakeholders, product owners, development teams, QA, and external vendors.
• Drive project planning, execution, risk management, budgeting, resource allocation, and reporting.
• Ensure timely delivery of projects within scope, schedule, and budget.
• Work closely with healthcare business teams to understand claims workflows, adjudication, provider/member data, and regulatory requirements.
• Facilitate Agile/Scrum ceremonies and ensure adherence to SDLC processes.
• Track project milestones, dependencies, risks, and escalations.
• Prepare executive-level status reports and communicate project health to leadership.
• Ensure compliance with healthcare regulations and organizational standards.

Mandatory Skills

• Strong experience as a Project Manager in Healthcare domain.
• Hands-on experience managing projects valued at $3M+.
• Deep understanding of Healthcare Claims processing lifecycle.
• Experience with payer systems, claims adjudication, eligibility, enrollment, and provider/member workflows.
• Strong stakeholder management and client-facing communication skills.
• Experience working in Agile and Waterfall environments.
• Expertise in project planning, budgeting, forecasting, and risk management.
• Proficiency with tools such as JIRA, Confluence, MS Project, or similar PM tools.

Preferred Skills

• PMP / Scrum Master certification preferred.
• Experience with Healthcare payer clients.
• Knowledge of HIPAA and healthcare compliance standards.
• Exposure to digital transformation or modernization programs.

Qualifications

• Bachelor’s degree in Computer Science, Information Systems, Healthcare Administration, or related field.
• 10+ years of IT experience with significant Project Management experience in Healthcare Claims domain.

Nice to Have

• Experience managing distributed/global teams.
• Exposure to cloud-based healthcare platforms and enterprise integrations.
• Vendor and offshore coordination experience