Project Manager

CV Resources

Greenville (SC)

On-site

USD 85,000 - 125,000

Full time

4 hours ago
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Job summary

CV Resources is partnering with a Third-Party Administrator (TPA) in Greenville, SC to find an experienced Project Manager with a strong understanding of the TPA environment. This role will oversee client implementations, operational initiatives, and cross-functional projects to ensure successful delivery of TPA services including claims administration, eligibility, and vendor integrations.

This is not a general PM role — candidates must understand how a TPA operates and be able to navigate

Qualifications

  • 2-5+ years in a TPA, insurance carrier, or health plan environment.
  • Direct experience with claims administration, eligibility, or account management preferred.
  • Proven experience managing implementations or operational projects.

Responsibilities

  • Lead new client implementations from onboarding through go-live (eligibility, plan setup, funding, reporting).
  • Develop and manage project timelines, deliverables, and internal accountability.
  • Coordinate across claims, eligibility, IT, and client services to ensure readiness.
  • Oversee vendor integrations (PBM, networks, telehealth, etc.).
  • Ensure projects translate into smooth day-to-day operations post go-live.
  • Identify gaps in processes and drive improvements.

Skills

Project management
TPA knowledge
Client communication
Cross-functional coordination
Vendor management
Scheduling & planning
Stakeholder management

Job description

CV Resources is partnering with a Third-Party Administrator (TPA) in Greenville, SC to findan experienced Project Manager with a strong understanding of the Third-Party Administrator (TPA) environment. This role will oversee client implementations, operational initiatives, and cross-functional projects to ensure successful delivery of TPA services including claims administration, eligibility, and vendor integrations.

This is not a general PM role — candidates must understand how a TPA operates and be able to navigate claims, eligibility, funding, and client expectations.

Key Responsibilities
Project & Implementation Management
  • Lead new client implementations from onboarding through go-live (eligibility, plan setup, funding, reporting, etc.)
  • Develop and manage project timelines, deliverables, and internal accountability
  • Coordinate across internal teams (claims, eligibility, IT, client services) to ensure readiness
  • Oversee vendor integrations (PBM, networks, telehealth, etc.)
Operational Oversight
  • Ensure projects translate into smooth day-to-day operations post go-live
  • Identify gaps in processes, workflows, or handoffs and drive improvements
  • Monitor service expectations including turnaround times, accuracy, and SLAs
  • Support ongoing operational initiatives and system enhancements
Client & Stakeholder Management
  • Serve as a primary point of contact during implementation and major initiatives
  • Run status calls and maintain clear communication with clients and internal teams
  • Manage escalations and ensure timely resolution of issues
  • Align expectations around scope, timelines, and deliverables
TPA-Specific Coordination
  • Work closely with claims and eligibility teams to ensure proper setup and administration
  • Coordinate plan designs, benefit structures, and funding arrangements
  • Understand and support compliance-related components (ASA agreements, plan requirements, reporting)
  • Partner on reporting, analytics, and performance tracking
Professional Communication & Documentation
  • Create clear, professional client-facing communications including emails, letters, reports, and meeting summaries
  • Maintain a high level of professionalism in all written and verbal communication
  • Document project plans, decisions, and processes in a clear and structured way
  • Develop and maintain SOPs for repeatable workflows
    Requirements
    Experience
    • 2-5+ years of experience in a TPA, insurance carrier, or health plan environment
    • Direct experience with claims administration, eligibility, or account management strongly preferred
    • Proven experience managing implementations or operational projects
    Knowledge
    • Strong understanding of TPA operations (claims processing, eligibility, funding, vendors, etc.)
    • Familiarity with benefit plans (medical, ancillary, or self-funded arrangements)
    • Experience working with PBMs, provider networks, or third-party vendors is a plus
    Skills
    • Professional office presence with the ability to communicate clearly and effectively with clients, vendors, and internal teams
    • Strong written communication skills, including the ability to draft professional emails, letters, and documentation
    • Advanced proficiency in Microsoft Office (Outlook, Excel, Word, PowerPoint, and Teams)
    • Highly organized with strong project management and follow-through
    • Ability to manage multiple projects and competing priorities
    • Strong problem-solving skills with the ability to identify issues and drive solutions quickly
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