Project Manager with Prior Authorization

Themesoft Inc.; Woodland (CA); On-site; USD 100,000 - 130,000; Full time

Job summary

Themesoft Inc. is seeking an experienced Project Manager to lead a prior authorization transformation project within a healthcare environment. The role requires strong project delivery expertise and a technical background to effectively drive execution within complex workflows.

The ideal candidate should have 8+ years of experience in IT and healthcare project management, proven ability to manage technical projects, and strong skills in stakeholder management and communication.

Qualifications

• 8+ years of Project Management experience in IT and healthcare domains.
• Proven experience managing complex, technical projects involving system integrations or platform implementations.
• Strong understanding of Software Development Lifecycle (SDLC) and Agile/Hybrid delivery models.

Responsibilities

• Lead end-to-end project delivery for a prior authorization initiative, ensuring alignment with business and IT objectives.
• Develop and manage detailed project plans, timelines, milestones, and deliverables.
• Coordinate cross-functional teams including business stakeholders, engineering, QA, and integrations teams.
• Drive requirements alignment, ensuring translation of business needs into technical deliverables.

Skills

Project Management experience in IT and healthcare domains

Managing complex, technical projects

Understanding of SDLC and Agile/Hybrid delivery models

Stakeholder management, communication, and problem-solving skills

Managing cross-functional distributed teams

Tools

JIRA

Confluence

Job description

We are seeking an experienced Project Manager to lead a prior authorization (PA) transformation/implementation project within a healthcare environment. This is a highly technical program, requiring strong coordination across business, technology, and integration teams.

The ideal candidate will bring solid project delivery expertise, with a technical background preferred to effectively drive execution across complex, system-driven workflows.

Required Qualifications

• 8+ years of Project Management experience in IT and healthcare domains
• Proven experience managing complex, technical projects involving system integrations or platform implementations
• Strong understanding of Software Development Lifecycle (SDLC) and Agile/Hybrid delivery models
• Demonstrated ability to manage cross-functional distributed teams
• Excellent stakeholder management, communication, and problem-solving skills

Preferred Qualifications

• Experience in Healthcare Payer domain, specifically Prior Authorization workflows
• Prior experience working on claims, utilization management, or care management systems
• Technical background (e.g., development, integration, architecture) strongly preferred
• Familiarity with tools such as JIRA, Confluence, or similar delivery management platforms
• Certifications such as PMP, Scrum Master, or equivalent are a plus

Key Responsibilities

• Lead end-to-end project delivery for a prior authorization initiative, ensuring alignment with business and IT objectives
• Develop and manage detailed project plans, timelines, milestones, and deliverables
• Coordinate cross-functional teams including business stakeholders, engineering, QA, and integrations teams
• Drive requirements alignment, ensuring translation of business needs into technical deliverables
• Manage project scope, schedule, cost, and quality constraints while proactively mitigating risks
• Oversee SDLC execution, including planning, development coordination, testing, and deployment support
• Facilitate key program meetings, including status updates, risk reviews, and stakeholder communications
• Track project progress, dependencies, and performance metrics, with clear reporting to leadership
• Identify and resolve technical and delivery challenges, ensuring minimal impact to timelines
• Ensure adherence to governance, compliance, and documentation requirements