Remote QNXT Claims Transformation Lead

HJSRLLC; Long Beach (CA); On-site; USD 140,000 - 190,000; Full time

Job summary

HJSRLLC is seeking a QNXT Program Manager to own the Claims workstream in a large-scale transformation, migrating from IKA to QNXT. This role starts 08/10/2026 and runs through 02/10/2027, located remotely from Long Beach, CA (PST hours).

You will lead end-to-end planning, governance, and delivery of all claims-related activities, coordinating with Provider Data, Benefits, Utilization Management, and Capitation to ensure accurate claims adjudication and go-live readiness.

Qualifications

• Bachelor’s degree in Business, Health Administration, Information Systems, or related field, or equivalent experience.
• Minimum 6 years of health plan/healthcare organization experience.
• Hands-on experience with QNXT (or comparable core admin platform) is required.
• Deep knowledge of healthcare payer claims operations and end-to-end claims lifecycle.
• Transformation leadership experience in large platform migrations and data conversions.

Responsibilities

• Lead end-to-end planning, execution, governance, and delivery of all claims-related implementation activities.
• Collaborate with product managers and leaders supporting Provider Data, Configuration, and Capitation to ensure a seamless migration.
• Oversee migration from IKA platform to QNXT, including testing, cutover, and post-go-live stabilization.
• Manage cross-functional alignment across Claims, Provider Data, Benefits, Utilization Management, and Capitation.
• Direct vendor and consultant collaboration to maintain scope, timelines, and architecture decisions.
• Proactively identify risks and dependencies to safeguard timelines and claims accuracy.

Skills

Program management

Healthcare payer claims

Stakeholder management

SQL

MS Office

Education

Bachelor’s degree in Business/Health Administration/Information Systems

Tools

SQL

MS Office

Visio

Access

Job description

HJSRLLC is seeking a QNXT Program Manager to own the Claims workstream in a large-scale transformation, migrating from IKA to QNXT. This role starts 08/10/2026 and runs through 02/10/2027, located remotely from Long Beach, CA (PST hours).

You will lead end-to-end planning, governance, and delivery of all claims-related activities, coordinating with Provider Data, Benefits, Utilization Management, and Capitation to ensure accurate claims adjudication and go-live readiness.