6+ years of program/project management experience in healthcare payer or TPA environments, with a strong focus on client and product implementations
4+ years of hands-on experience across enrollment/eligibility, benefit administration, claims administration, provider/member services/portals, and finance for self-funded client implementations
Deep knowledge of TPA environments, with proven ability to lead new client onboarding and ongoing production support
Strong understanding of healthcare operations, data flows, and regulatory requirements including upcoming 2026 mandates, plus excellent communication across technical and business stakeholders
Requirements:
Lead end-to-end project management for TPA initiatives across medical management, provider, eligibility, claims, and customer care; manage onboarding of new self-funded clients including planning, testing, and go-live
Oversee production management for existing clients, ensuring service delivery, issue resolution, and continuous improvement; proactively manage RAID and mitigation strategies
Develop and manage detailed project plans with timelines, milestones, budgets, resource allocation, risks, and dependencies; coordinate with business, operations, IT, vendors, and stakeholders to deliver solutions
Ensure regulatory compliance and readiness for 2026 mandates; drive process improvements across TPA/payer functions and facilitate cross-functional alignment and communications
Job description
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
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
