External Job Posting Title Senior Level – Production Integration & Implementation Planning

Peraton; Maryland; Hybrid; USD 146,000 - 234,000; Full time

Job summary

Peraton is seeking a Senior Level – Production Integration & Implementation Planning lead to drive early planning activities to transition the ClaimsCore PoC toward a scalable production implementation. You will coordinate with CMS, MACs, Cognizant and partners on an integrated approach emphasizing Tier 1 interfaces, MAC integration and transition planning.

The role translates PoC insights into an executable production strategy and contributes to the Production IMPS, TCO analysis, and

Qualifications

• Minimum 12 years with BS/BA; or 10 years with MA/MS.
• TriZetto Facets or comparable enterprise claims-adjudication platform experience.
• Experience planning or executing complex production implementations with multiple systems and stakeholders.
• Strong healthcare payer or government claims-processing background.
• Experience with enterprise systems integration, interface planning and implementation.
• Experience developing integrated implementation plans, roadmaps, schedules and dependency models.
• Ability to work with senior government and technology partners.
• Executive communication, facilitation and planning skills.
• Ability to obtain a Public Trust.

Responsibilities

• Lead development of the ClaimsCore production implementation strategy and roadmap.
• Lead planning of Tier 1 interfaces: inventory, ownership, dependencies, specs, connectivity, testing, certification, sequencing and readiness.
• Develop MAC integration and transition planning framework for onboarding MACs.
• Identify interfaces, data exchanges, processes and readiness requirements with CMS and MACs.
• Support Production IMPS with workstreams, critical path, staffing, gates and risks.
• Develop sequencing for PoC to production parity and stabilization.
• Coordinate data migration, validation and MAC-specific transition activities.
• Coordinate with Claims Accuracy & Business Rules on migration and validation.
• Coordinate with Tech Ops & Security on cloud infra, security and DR.
• Coordinate with Change Management for MAC engagement, training and cutover.
• Support five-year TCO model including costs and drivers.
• Identify assumptions and alternative implementation scenarios.
• Support program staffing for Peraton, Cognizant, CMS and MACs.
• Facilitate cross-workstream planning and capture dependencies and decisions.
• Identify risks early and propose mitigations.

Skills

Enterprise systems integration

Program/Project management

Stakeholder coordination

Executive communication

SAFe/Agile experience

PMI PMP Certification

Public Trust readiness

Education

Bachelor's degree

MA/MS degree

Tools

TriZetto Facets

HIGLAS

X12 (837/835)

AWS/hybrid-cloud

Job description

Responsibilities

The Senior Level – Production Integration & Implementation Planning will lead early planning activities required to transition the ClaimsCore solution from Proof of Concept (PoC) evaluation toward a scalable production implementation. You will work across Peraton, CMS, MACs, Cognizant and other technology partners to develop the integrated implementation approach for production, with initial emphasis on Tier 1 interface integration, MAC integration and transition planning, production implementation sequencing, cost modeling, dependency identification, resource requirements, and operational readiness. You will translate lessons learned and technical evidence from the ClaimsCore PoC into an executable production implementation strategy and will be a key contributor to the Production Integrated Master Plan and Schedule (IMPS), Total Cost of Ownership (TCO) analysis, integration planning, MAC transition planning, and other pre-production planning deliverables. The position requires someone capable of operating at both the strategic and execution levels—understanding complex healthcare claims environments while converting technical, operational and stakeholder requirements into a realistic production roadmap.

Primary Responsibilities

• Lead development of the ClaimsCore production implementation strategy and roadmap, incorporating PoC findings, CMS requirements, technical dependencies, operational constraints, and lessons learned.
• Lead planning of Tier 1 interfaces: I/F inventory, ownership, dependencies, specifications, connectivity, testing, certification, implementation sequencing and production readiness.
• Develop the overall MAC integration and transition planning framework, outline the steps to onboard and transition MACs into the future ClaimsCore operating environment.
• Work with CMS and MAC stakeholders to identify current-state interfaces, dependencies, data exchanges, business processes, transition constraints and readiness requirements.
• Support development of the Production IMPS, including workstreams, critical path, dependencies, staffing assumptions, stage gates, entry/exit criteria, implementation waves and risks.
• Develop implementation sequencing recommendations for moving from PoC capabilities through parity, production readiness, MAC onboarding, deployment and stabilization.
• Coordinate with Data Migration team to incorporate historical data migration, reconciliation, data validation and MAC-specific data transition activities into the production roadmap.
• Coordinate with Claims Accuracy & Business Rules team on business-rule migration, configuration, regression testing, claims parity and validation activities into production planning.
• Coordinate with Tech Ops & Security to detail cloud infrastructure, environments, security authorization, performance, disaster recovery, monitoring and operational readiness activities.
• Coordinate with Change Management to incorporate MAC stakeholder engagement, communications, training, organizational readiness and cutover preparation.
• Support development of the five-year Total Cost of Ownership model, including implementation costs, infrastructure/cloud costs, licensing, labor, integration, migration, operations/support, MAC transition costs and other major cost drivers.
• Identify production implementation assumptions and develop low/base/high or alternative implementation scenarios where appropriate.
• Support development of program staffing and resource models, for stakeholders including Peraton, Cognizant, CMS and the MACs.
• Facilitate cross-workstream production planning sessions and ensure assumptions, dependencies and decisions are captured and incorporated into the integrated plan.
• Identify implementation risks early and develop recommended mitigation strategies.

Qualifications

Required Qualifications

• Minimum of 12 years with BS/BA; or 10 years with a MA/MS degree.

• TriZetto Facets or comparable enterprise claims-adjudication platform experience.
• Demonstrated experience planning or executing complex production implementations involving multiple systems, interfaces and stakeholder organizations.
• Strong experience with healthcare payer or government claims-processing environments.
• Experience with enterprise systems integration, interface planning and implementation.
• Experience developing integrated implementation plans, roadmaps, schedules and dependency models.
• Experience coordinating technical, data, operational and business workstreams.
• Experience developing or contributing to implementation cost estimates, TCO models or business cases.
• Demonstrated ability to work directly with senior government/customer stakeholders and technology partners.
• Strong executive communication, facilitation and planning skills.
• Ability to obtain a Public Trust.

Highly Preferred Qualifications

• 12+ years of experience managing large-scale healthcare, claims-processing, systems integration, or enterprise modernization programs.
• Medicare Fee-for-Service or CMS claims-processing experience.
• MAC operational or systems integration experience.
• Experience with X12 healthcare transactions, including 837/835 and related healthcare interfaces.
• Experience with claims-system data migration and business-rule conversion.
• Knowledge of CMS’ Healthcare Integrated General Ledger Accounting System (HIGLAS)
• AWS/hybrid-cloud modernization experience.
• Experience transitioning large government systems from pilot/PoC through production.
• PMI PMP Certification
• SAFe/Agile experience in large multi-team programs.

Peraton Overview

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world’s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can’t be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we’re keeping people around the world safe and secure.

Target Salary Range

$146,000 - $234,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual’s experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.

EEO

EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.