QNXT Claims Lead (Temp) – Partially Remote

SCAN Group; United States; Hybrid; USD 70,257 - 101,942; Full time

Job summary

SCAN, a nonprofit health organization, seeks a Program Lead for the QNXT implementation to manage end-to-end claims migration from IKA. You will coordinate across Claims, Provider Data, and Configuration, ensuring quality and timely delivery while guiding SMEs and vendors through a complex transformation.

The role requires senior-level program management, with heavy emphasis on governance, risk management, and cross-functional collaboration in a partially remote setting.

Qualifications

• Bachelor's degree or equivalent; minimum 6 years in health plan/healthcare or related industry.
• Master's degree preferred (MBA/MPH/MS).
• Strong knowledge of healthcare payer claims operations and end-to-end lifecycle.
• Experience leading large cross-functional system implementations or transformations.

Responsibilities

• Act as the accountable program lead for the Claims implementation of QNXT with end-to-end responsibility.
• Lead the integrated implementation plan across business, operational, data, testing, training, readiness, and cutover activities.
• Coordinate and drive alignment across supporting workstreams for provider contracts, benefits, UM/business rules, and capitation.
• Define future state workflows and requirements with SMEs, technology teams, and consultants.
• Own governance for the claims implementation, including status reporting and risk management.
• Coach cross-functional teams and coordinate with implementation consultants and vendors.
• Lead readiness activities for testing, mock conversions, cutover, and go-live.

Skills

Leadership

Communication

Stakeholder management

Strategic thinking

Coaching teams

Change leadership

Education

Bachelor's degree in Business/Health Administration/IS

Master's degree (preferred) MBA/MPH/MS

Tools

SQL

Visio

Microsoft Office

Job description

SCAN, a nonprofit health organization, seeks a Program Lead for the QNXT implementation to manage end-to-end claims migration from IKA. You will coordinate across Claims, Provider Data, and Configuration, ensuring quality and timely delivery while guiding SMEs and vendors through a complex transformation.

The role requires senior-level program management, with heavy emphasis on governance, risk management, and cross-functional collaboration in a partially remote setting.