Senior Project Manager – US Health Payer Projects (Remote)

Job Title: Senior Project Manager / Delivery Owner – US Health Payer Projects

Location: Remote

Working Hours: 3 PM IST to 12 AM IST

Experience Required: Minimum 8 years

Employment Type: Full-Time

Department: Healthcare Client Delivery / Program Management

The Senior Project Manager / Delivery Owner will lead end-to-end delivery for complex U.S. healthcare payer programs and take full ownership of timelines, scope, quality, and stakeholder management. The ideal candidate has deep experience delivering payer initiatives—particularly CMS interoperability-related projects—and can successfully drive multiple concurrent workstreams, including CMS-9115, CMS-0057, Provider Directory, and data feed ingestions into a Clinical Data Repository (CDR). This role requires strong execution discipline, comfort working with technical teams, and the ability to manage client expectations while ensuring high-quality outcomes.

• Own end-to-end program delivery across multiple U.S. payer projects, including scope, schedule, budget tracking, risks, dependencies, and quality.
• Lead delivery for ongoing initiatives such as CMS-9115, CMS-0057, Provider Directory, and CDR feed ingestion programs (batch/real-time integrations).
• Build and maintain integrated project plans and delivery roadmaps; establish milestone tracking and sprint execution cadence.
• Run Agile/Scrum ceremonies (standups, sprint planning, refinement, retrospectives) and ensure predictable delivery and transparency.
• Create and manage RAID logs, change requests, and dependency plans; proactively escalate issues and drive resolution.
• Translate payer and regulatory requirements into actionable execution plans (epics/stories), aligning product, engineering, data, QA, and DevOps.
• Manage client governance: weekly status meetings, steering committee updates, action tracking, decision logs, and stakeholder communication.
• Coordinate cross-functional teams (engineering, data engineering, QA, security, DevOps) and ensure readiness for UAT and production releases.
• Define and enforce delivery standards: Definition of Ready/Done, acceptance criteria, documentation, release checklists, and post-release stabilisation.
• Ensure compliance-aligned delivery practices for healthcare data environments (privacy, audit readiness, operational controls).
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• Bachelor’s degree in Engineering, Computer Science, Information Systems, Healthcare Informatics, or a related field.
• 8+ years of experience in Project/Program Management delivering technology projects, with significant experience in the U.S. health payer domain.
• Proven track record managing multiple concurrent payer projects and owning delivery commitments end-to-end.
• Strong understanding of payer operations and data flows (member, eligibility, claims, provider, authorisations) and healthcare reporting contexts.
• Experience delivering CMS and payer interoperability programs (e.g., CMS-0057/CMS-9115 or similar regulatory initiatives).
• Working understanding of interoperability standards and healthcare data exchange concepts: FHIR, HL7, X12 EDI (270/271, 837/835, 278).
• Strong experience with Agile/Scrum methodologies and tools such as JIRA/Azure DevOps, Confluence, and collaboration tools.
• Excellent stakeholder management skills with the ability to communicate clearly with both technical and non-technical audiences.
• Strong documentation and execution discipline (project plans, status reports, meeting notes, action items, risk/issue logs).
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• Experience delivering Provider Directory / Plan-Net style implementations and provider data governance initiatives.
• Experience with clinical/analytics platforms and data repositories (CDR/EDW/lakehouse) and ingestion patterns (SFTP, APIs, streaming, ETL/ELT).
• Familiarity with cloud environments and data tooling (Azure/AWS, Snowflake, Databricks, ADF, Kafka, etc.).
• PMP, PRINCE2, CSM/PSM, SAFe or similar project/agile certifications.
• Experience working with payer platforms or ecosystems (QNXT, HealthEdge, MHK, Epic Tapestry, etc.).
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• Strong ownership mindset with a bias for action and accountability.
• Excellent verbal and written communication, especially for executive updates and client management.
• Skilled at conflict resolution, negotiation, and driving decisions in ambiguous environments.
• Highly organised, detail-oriented, and comfortable managing complex dependencies across teams.
• Ability to thrive in fast-paced environments while maintaining quality and delivery predictability.