QNXT Program Manager

HS QNXT Program Manager
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HJ Staffing is a Houston-based staffing agency and Women Owned Minority Business Enterprise that connects businesses with qualified talent through temporary staffing, direct placement, and HR consulting services.
HJ Staffing
Employee count: 11-50
United States only

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We are seeking an QNXT Program Manager to take full accountability for the Claims Workstream within a large-scale QNXT core platform transformation, including migrating from the current IKA platform.

Location: Long Beach, CA (100% Remote)

Schedule: Monday – Friday, 8:00 AM – 5:00 PM (PST)

Start Date: 08/10/2026

End Date: 02/10/2027

In this role, you will lead the end-to-end planning, execution, governance, and delivery of all claims-related implementation activities. You will collaborate closely with product managers and leaders supporting Provider Data, Configuration (provider contracts, benefits, utilization management, business rules), and Capitation to ensure a seamless migration, precise claims adjudication, and operational readiness for go-live.
Key Responsibilities
- Program Leadership & Migration: Accountable for end-to-end implementation and issue resolution for the QNXT Claims workstream, driving the complete migration off the IKA platform.
- Integrated Planning & Governance: Manage the claims implementation plan across operations, configuration, testing, data conversion, training, cutover, and post-go-live stabilization. Maintain RAID logs, decision logs, and status reporting.

- Cross-Functional Workstream Alignment: Coordinate alignment across Claims, Provider Data, Benefits, Utilization Management, and Capitation to ensure accurate future-state claims adjudication, pricing, and payment.
- Vendor & Consultant Management: Direct day-to-day collaboration with external implementation consultants and software vendors to ensure scope, timelines, deliverables, and architecture decisions stay on track.
- Testing, Cutover & Stabilization: Lead preparations for system testing, defect triage, mock conversions, go-live cutover, and post-implementation stabilization while validating contingency and readiness plans.
- Risk & Change Management: Proactively identify execution risks, workflow gaps, and dependency issues to safeguard project timelines, claims accuracy, and stakeholder confidence.

Required Qualifications
- Education: Bachelor’s degree in Business, Health Administration, Information Systems, or a related field (or equivalent combination of education and experience).
- Experience: Minimum 6 years of related experience within a health plan, managed care, or healthcare organization.
- Core Platform Expertise: Hands-on experience with QNXT (or a directly comparable core administrative platform) is required .
- Domain Knowledge: Deep expertise in healthcare payer claims operations and the end-to-end claims lifecycle (adjudication, pricing, payment, and provider/benefit configuration interactions).
- Transformation Leadership: Proven experience leading large, cross-functional system implementations or platform migrations involving data conversion, system testing, defect triage, mock conversions, cutover planning, and go-live stabilization.

- Technical Proficiency: Advanced skills with Microsoft Office Suite (Word, Excel, PowerPoint, Teams), Visio, Access, and SQL.
- Work Schedule: Ability to work standard PST business hours (Monday – Friday, 8:00 AM – 5:00 PM PST).

Preferred Qualifications
- Master’s degree (MBA, MPH, MHA, or MS in Information Systems).
- Direct experience leading IKA-to-QNXT platform migrations .
- Experience driving AI-driven operational improvements within healthcare claims environments.

What Will Make You Successful
- Ability to take end-to-end ownership of a high-stakes, enterprise claims implementation with minimal supervision.
- Strong consensus-building and coaching skills to align senior leadership, technical teams, consultants, and vendors around common priorities.
- Comfort navigating fast-paced, complex, and ambiguous transformation environments.
- Sharp analytical, risk-management, and decision-making skills to resolve blockers before they impact critical path timelines.
- Exceptional executive-level communication and change-leadership abilities.

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About the job
Apply before
Nov 07, 2026
Posted on
Sep 08, 2026
Job type
Full Time
Experience level
Manager Senior

Education
Bachelor degree

Experience

6 years minimum

Experience accepted in place of education

Location requirements
Suggest an edit

United States

Hiring timezones
Show UTC offsets

United States +/- 0 hours

Job categories
Healthcare Program Management Claims Management Health Plan Operations QNXT Program Manager Project Program Manager NCQA Program Manager

Skills
QNXT IKA Platform Claims Adjudication Claims Operations Provider Configuration Benefit Configuration Microsoft Suite Excel PowerPoint Microsoft Teams Microsoft Visio SQL Platform Migration Healthcare IT Healthcare Payer Operations RAID Management Access Data Conversion Software Testing Cutover Planning Vendor Management Change Management System Testing Defect Triage Program Management Healthcare Claims

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About HJ Staffing

Learn more about HJ Staffing and their company culture.

View company profile

Finding the right talent shouldn't feel like guesswork. HJ Staffing exists to solve the persistent challenge businesses face in connecting with qualified professionals who actually fit their needs. As a certified Employment Agency and Women Owned Minority Business Enterprise (WMBE), we leverage over a decade of Human Resource and Talent Acquisition expertise to bridge the gap between organizations seeking growth and candidates pursuing meaningful career opportunities.

Our approach combines personalized service with modern recruitment techniques, allowing us to deliver exceptional human resource support across temporary staffing, direct placement, and executive search. We understand that workforce challenges require nuanced solutions - from administrative support to specialized healthcare professionals. This commitment to customized matching has established us as a trusted partner for businesses navigating the complexities of talent acquisition in today's dynamic employment landscape.

Apply now
Job expired?

Please let HJ Staffing know you found this job on Himalayas. This helps us grow!
Apply now

About the job
Apply before
Nov 07, 2026
Posted on
Sep 08, 2026
Job type
Full Time
Experience level
Manager Senior

Education
Bachelor degree

Experience

6 years minimum

Experience accepted in place of education

Location requirements
Suggest an edit

United States

Hiring timezones
Show UTC offsets

United States +/- 0 hours

Job categories
Healthcare Program Management Claims Management Health Plan Operations QNXT Program Manager Project Program Manager NCQA Program Manager

Skills
QNXT IKA Platform Claims Adjudication Claims Operations Provider Configuration Benefit Configuration Microsoft Suite Excel PowerPoint Microsoft Teams Microsoft Visio SQL Platform Migration Healthcare IT Healthcare Payer Operations RAID Management Access Data Conversion Software Testing Cutover Planning Vendor Management Change Management System Testing Defect Triage Program Management Healthcare Claims

Browse similar jobs
Remote Manager Healthcare-Program-Management Jobs Remote Full Time Healthcare-Program-Management Jobs Remote Manager Healthcare-Program-Management Jobs in United States Remote Full Time Jobs in United States Remote Healthcare-Program-Management Jobs in United States

Claim this profile HS HJ Staffing

Company size

11-50 employees

Founded in

2016

Chief executive officer

Constance Jones

Markets
Talent Acquisition and Sourcing Temporary Staffing (Contract Temp to Hire) Employment Agency Services Human Resources (HR) Services Direct Hire Permanent Placement Executive Search Healthcare Staffing Staffing and Recruiting Administrative and Office Staffing Workforce Solutions HR Outsourcing

Employees live in
United States

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