Technical Delivery Manager with Claims EXP

LiveMindz Inc.; United States; Remote; USD 120,000 - 160,000; Full time

Job summary

LiveMindz Inc. is seeking a Technical Delivery Manager with Claims EXP to lead complex delivery across payer operations. Remote role in the United States, focusing on modernization of claims, core administration, and platform improvements.

You will drive forecasting, risk management, and executive communication while coordinating multiple vendors and internal teams. The ideal candidate brings 10+ years in healthcare payer domains and 7+ years in technical delivery, with hands-on EDI experience

Qualifications

• 10 years in healthcare payer with claims-related experience.
• 7 years in technical delivery or program management with multi-team ownership.
• Led a large modernization initiative involving legacy systems.
• Hands-on experience with healthcare EDI (837/835/270/271/276/277).
• Understanding of full software delivery lifecycle and operational transition.
• Experience managing plans, milestones, and release readiness.
• Ability to forecast and communicate delivery decisions to executives.
• Experience in matrixed, evolving environments with changing roadmaps.
• Proficiency with Jira/Confluence and Agile metrics.
• Knowledge of AI productivity tools and workflows.

Skills

Payer domain expertise

Technical delivery leadership

SDLC governance

Agile / Scrum

Delivery forecasting

Stakeholder communication

Vendor coordination

Matrixed environment navigation

AI productivity tools parity

Cloud / platform modernization

Education

Bachelor’s degree or equivalent

Tools

Jira

Confluence

Power BI

CI/CD

Job description

Role: Technical Delivery Manager with Claims EXP

Location: Remote

Required Qualifications

• 10 years of experience in healthcare payer organizations with practical knowledge of claims, adjudication, eligibility, enrollment, provider workflows, member workflows, and payer operations.
• 7 years in technical delivery, program management, software delivery, project management, Scrum leadership, or a related role; demonstrated ownership of complex multi-team delivery.
• Proven success leading at least one large modernization initiative involving legacy, claims, core administration, platform, architecture, data, cloud, or enterprise technology transformation.
• Hands‑on experience delivering healthcare EDI solutions or operations involving 837, 835, 270/271, 276/277, enrollment, acknowledgments, exception handling, or reconciliation.
• Strong understanding of the software development lifecycle, including discovery, architecture, planning, development, testing, release, cutover, hypercare, and operational transition.
• Experience managing integrated plans, milestones, commitments, capacity, dependencies, risks, recovery actions, and release readiness.
• Ability to translate technical constraints and delivery evidence into clear forecasts, tradeoffs, decisions, and executive communications.
• Experience operating in highly matrixed and ambiguous environments with evolving requirements, roadmaps, priorities, and architecture.
• Proficiency with Jira, Confluence, Agile metrics, sprint governance, release planning, and risk‑management practices.
• Working knowledge of approved AI productivity tools, agents, reusable skills, prompts, automation, or workflow optimization.
• Bachelor’s degree or equivalent practical experience.

Preferred Qualifications

• Direct experience with Aetna/CVS Health, Meritain Health, Elevance Health, UnitedHealthcare, Humana, Cigna, Centene, Molina, or another large payer.
• Experience with platform decomposition, API enablement, event‑driven architecture, real‑time data services, cloud transformation, or distributed systems.
• Familiarity with payer legacy applications, claims engines, EDI gateways, data platforms, business‑rules engines, APIs, and operational processes.
• Experience coordinating vendors, consulting firms, clearinghouses, or external delivery partners.
• Practical DevOps, CI/CD, test automation, observability, release‑readiness, dashboarding, or Power BI experience.
• Relevant delivery, program‑management, Agile, Scrum, SAFe, cloud, or healthcare‑domain certifications.

Required Evidence of Impact

• The delivery or business problem that existed and why it mattered.
• The actions personally taken, including decisions influenced, conflicts resolved, escalations led, and teams held accountable.
• The metrics used to assess delivery health and guide intervention.
• Measurable outcomes such as improved predictability or velocity, reduced slippage, shorter lead time, better release quality, fewer EDI rejections, faster claims processing, higher automation, reduced operational effort, or improved readiness.