Program Manager - Claims/Interoperability

Required Skills & Experience

• 5+ years of enterprise Program or Project Management experience, including 3+ years leading large-scale cross-functional initiatives.
• Experience managing healthcare, behavioral health, health information exchange (HIE), claims, interoperability, or payer/provider technology programs.
• Experience developing and maintaining integrated project plans, governance structures, risk management processes, and executive reporting.
• Strong stakeholder management experience working across business, technology, product, engineering, and external vendor teams.
• Experience performing business process analysis, requirements gathering, and operational assessments related to healthcare systems or data initiatives.
• Bachelor's degree in Business, Healthcare Administration, Information Systems, Public Administration, or related field.

Nice to Have Skills & Experience

• PMP Certification (PMI) or equivalent project/program management certification.
• Experience working with Electronic Health Records (EHRs), interoperability standards, healthcare claims workflows, or healthcare data exchanges.
• Experience supporting State of California healthcare programs, behavioral health initiatives, or public sector technology transformations.

Job Description

Insight Global is seeking a Program Manager: Claims & Interoperability to join a critical project with one of the largest consulting and advisory firms in the world. This individual will lead a large-scale behavioral health data and claims initiative focused on improving claims processing, interoperability, stakeholder alignment, and program execution across the State of California. The ideal candidate will serve as the operational leader driving program governance, delivery planning, risk management, and cross-functional collaboration between business, policy, product, and engineering teams. This role requires a strategic program manager who can balance executive-level communication with hands-on project execution in a highly regulated healthcare environment.

Responsibilities:

• Develop, maintain, and manage integrated program plans, timelines, milestones, dependencies, and deliverables across multiple stakeholder groups.
• Establish and maintain program governance frameworks, operating models, escalation paths, and team engagement processes.
• Lead cross-functional coordination between business, policy, technology, product, engineering, and external partner teams.
• Identify, document, track, and mitigate program risks, issues, and blockers while ensuring timely escalation when needed.
• Drive claims and interoperability initiatives by monitoring progress, removing obstacles, and ensuring alignment with business objectives and regulatory requirements.
• Conduct business and operational analyses, including claims process assessments, interoperability gap analyses, and electronic health record (EHR) landscape evaluations.
• Partner with Product and Delivery leadership to support roadmap development, release planning, and successful implementation of program initiatives.
• Facilitate stakeholder meetings, executive steering committees, and working sessions, documenting decisions, action items, and follow-up activities.
• Prepare executive dashboards, status reports, risk logs, and other program management artifacts for leadership audiences.
• Collaborate with policy teams and subject matter experts to translate program requirements into actionable operational and technical solutions.