Remote Claims Systems Manager: Lead & Optimize

ca159cb6-724b-4d65-a386-ef202361ead9; Yorktown (VA); Remote; USD 100,000 - 130,000; Full time

Benefits offered by this job

Annual incentive bonus

Medical, dental, and vision insurance

Vacation and sick time accrual

13 paid holidays

State Pension

401(k) with employer match

Life and disability insurance

Wellness Programs

Public Service Loan Forgiveness

Job summary

Vaya Partners is seeking a Claims System Manager to provide strategic leadership for the Claims Management software and oversee a team of Systems Analysts. You will coordinate BRDs, vendor contracts, and service desk resolution, while aligning initiatives with the organization’s mission and Medicaid rules.

The role requires strong governance, risk management, and cross-functional collaboration across ISD. You will supervise staff, manage vendor relationships, and deliver regular status updates

Qualifications

• Bachelor’s degree and 5+ years in management of data systems, focus on claims or health insurance systems a plus.
• Seven years of experience in a management/supervisory role preferred.
• Knowledge of NC Medicaid rules and regulations is a plus.

Responsibilities

• Provide strategic roadmap for claims management software and oversee staff and vendors.
• Coordinate BRDs, vendor contracts, and ticket resolution with stakeholders.
• Monitor project health, deadlines, and escalations; ensure timely issue resolution.
• Collaborate with ISD and PMO to align software initiatives with organizational goals.
• Ensure compliance with policies and Medicaid regulatory requirements.

Skills

Leadership & team mgmt

Stakeholder comms

Analytical thinking

Vendor management

Project management

Claims processing knowledge

Regulatory awareness (Medicaid)

Education

Bachelor’s degree in Business Administration, Information Systems Management, Health Information Management, or closely related field

Tools

Microsoft O365

Service desk software

Job description

Vaya Partners is seeking a Claims System Manager to provide strategic leadership for the Claims Management software and oversee a team of Systems Analysts. You will coordinate BRDs, vendor contracts, and service desk resolution, while aligning initiatives with the organization’s mission and Medicaid rules.

The role requires strong governance, risk management, and cross-functional collaboration across ISD. You will supervise staff, manage vendor relationships, and deliver regular status updates