Medicare Technical Project Manager: Systems Integration

Peraton

Herndon (VA)

On-site

USD 135,000 - 216,000

Full time

12 days ago

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Job summary

Peraton invites an experienced Manager, Technical Project Management to lead the CMS ClaimsCore modernization efforts in the US. The role blends technical program leadership with deep healthcare claims processing knowledge, coordinating across CMS, MACs, Cognizant/Facets, and vendors to drive integration, data migration, testing, and production readiness.

You will translate complex Medicare requirements into executable plans, manage cross-system dependencies, and deliver phased implementation

Qualifications

10+ years of progressively responsible technical project/program management experience in enterprise systems implementation.
Demonstrated experience leading largescale systemsintegration initiatives involving APIs, EDI, batch/file, database, or multisystem connectivity.
Demonstrated experience leading or coordinating large data migrations involving missioncritical systems.
Healthcare payer or claimsprocessing experience, preferably with institutional and professional claims.
Strong understanding of enterprise architectures, interfaces, ICDs/specifications, system dependencies, integration testing, and production cutover.
Experience with interface inventories, dependency mapping, sourcetotarget data mapping, errorhandling approaches, reconciliation, and operational support models.
Experience managing multidisciplinary technical teams and coordinating with infrastructure, application, business, and vendor stakeholders.
Experience developing integrated schedules, risk registers, dependency matrices, and executivelevel reporting.
Ability to communicate effectively with engineers, architects, SMEs, executives, government customers, and external partners.
Ability to lead teams through ambiguity and develop actionable plans when requirements are evolving.
Ability to obtain a Public Trust.
US Citizen or a Green Card Holder.

Responsibilities

Lead complex technical initiatives involving systems integration, data migration, claimsprocessing capabilities, and Medicare shared services.
Develop and manage integrated implementation plans covering interfaces, data flows, configuration, testing, operational readiness, and production transition.
Coordinate technical activities across application development, integration, infrastructure, security, data, testing, and business teams.
Lead interface discovery and planning activities, including currentstate analysis, requirements, ICD/spec development, testing, certification, cutover, and production readiness.
Work with CMS, MACs, and SMEs to understand beneficiary, eligibility, provider, claims history, claimstatus, adjudication, and pricing/editing dependencies.
Lead complex datamigration activities including sourcesystem analysis, mapping, transformation, reconciliation, historicaldata use, data quality, and migration validation.
Ensure migration/integration designs incorporate historical claims information, accumulators, beneficiary/eligibility attributes, and provider data required to process future claims.
Coordinate implementation planning with ClaimsCore adjudication services and CMS shared services (e.g., CWF, PECOS, HIGLAS, pricing/editing services).
Drive resolution of crossteam dependencies, technical issues, architectural decisions, risks, and implementation blockers.
Develop executivelevel status updates, recommendations, risk assessments, and implementationreadiness materials.
Support production planning including MAC onboarding, phased implementation waves, cutover, operational readiness, and stabilization.
Define measurable entry/exit criteria and completion evidence for major implementation milestones.
Facilitate technical working sessions with CMS, MACs, vendors, and engineering teams, translating discussions into clear decisions and accountable actions.
Provide leadership to multidisciplinary teams and assume responsibility for a major ClaimsCore production workstream.