Job Title: Delivery Lead / Program Manager-Healthcare Payer
Location : 100% Remote Role
Duration : 6+ Months Contract with Possible Extension or Fulltime
Teams Meeting Interview
Job Description:
Experienced Delivery Leads / Program Managers to lead execution of a large portfolio of state-mandated regulatory and compliance initiatives across Medicaid and healthcare payer operations. This role will be responsible for coordinating multiple concurrent workstreams supporting regulatory changes, backlog remediation, and 2027 implementation readiness across Claims, Eligibility, Regulatory Reporting, Provider, Data, and Integration platforms.
The Delivery
Lead will serve as the primary orchestration point across business, regulatory, architecture, engineering, testing, data, operations, and vendor teams, ensuring successful and compliant delivery of regulatory commitments while managing risks, dependencies, capacity, schedules, and stakeholder communications.
Key Responsibilities
Program & Delivery Leadership
Lead multiple concurrent regulatory programs and workstreams across the Regional Regulatory portfolio.
Establish integrated delivery plans that align regulatory deadlines, business priorities, and application roadmaps.
Drive execution across multiple releases and implementation waves.
Ensure delivery commitments are met while maintaining quality, compliance, and operational readiness.
Planning & Dependency Management
Develop and maintain integrated program plans, milestones, release schedules, and implementation calendars.
Identify and actively manage cross-program dependencies involving:
Claims platforms
Eligibility systems
Regulatory reporting solutions
Data warehouse and analytics platforms
EDI and integration platforms
Vendor and third-party systems
Coordinate sequencing of deliverables across multiple application teams.
Risk & Issue Management
Establish proactive risk management processes.
Identify regulatory, operational, technical, testing, and implementation risks.
Facilitate issue resolution and escalation management.
Maintain executive-level visibility into risks, mitigation plans, and decision requirements.
Stakeholder Management
Serve as the primary coordination point between:
Regulatory and Compliance teams
Medicaid Business Operations
Product Owners
Business Analysts
Solution Architects
Engineering Teams
Data and Reporting Teams
Quality Engineering Teams
Release and Production Support Teams
Executive Leadership
Drive governance meetings, steering committees, status reviews, and executive updates.
Delivery Governance
Establish and manage:
Program governance structure
RAID logs (Risks, Assumptions, Issues, Dependencies)
Milestone tracking
Resource forecasting
Budget and capacity planning
Executive dashboards and reporting
Ensure regulatory commitments are tracked through implementation and validation.
Cross-Functional Coordination
Coordinate delivery activities across:
Application Development
Mainframe Teams
Java and Digital Platforms
Facets Configuration Teams
DataStage and Talend Development Teams
Integration Teams
Cloud Platforms
Testing and QA Organizations
Facilitate alignment between business readiness and technical delivery schedules.
Release & Implementation Management
Oversee release readiness assessments and deployment planning.
Coordinate production implementation activities.
Drive operational readiness, training, communications, and transition-to-support activities.
Ensure successful stabilization during post-production support periods.
Executive Communications
Prepare and deliver executive-level program reporting.
Communicate delivery progress, risks, decisions, budget status, and implementation readiness.
Provide concise and actionable updates to leadership and regulatory stakeholders.
Required Qualifications
Bachelor's degree in Business, Information Systems, Healthcare Administration, Engineering, or related field.
15+ years of program, project, or delivery management experience.
10+ years leading large-scale healthcare payer transformation or regulatory programs.
Demonstrated experience managing multiple parallel delivery teams and workstreams.
Experience delivering regulatory and compliance initiatives within Medicaid, Medicare, or Commercial healthcare environments.
Strong understanding of:
Program and portfolio management
SDLC methodologies
Agile and SAFe frameworks
Risk and dependency management
Executive stakeholder management
Preferred Qualifications
Experience managing state Medicaid regulatory implementations.
Knowledge of CMS regulations and Medicaid managed care operations.
Experience with healthcare payer platforms including:
Facets
QNXT
HealthRules
Custom claims and eligibility systems
Experience coordinating complex data and integration initiatives involving:
EDI transactions
APIs
Data warehouse platforms
Regulatory reporting solutions
PMP, PgMP, PMI-ACP, SAFe Program Consultant (SPC), or SAFe Release Train Engineer (RTE) certification preferred.
Program Management Tools
Azure DevOps
Jira
Confluence
Microsoft Project
Smartsheet
Power BI
Excel
Core Competencies
Portfolio Delivery Management
Regulatory Program Leadership
Dependency Management
Risk Management
Financial & Capacity Planning
Executive Communication
Vendor Management
Release Management
Stakeholder Alignment
Organizational Change Management