Job Requirements
Remote
Public Trust Polygraph Unspecified
Career Level not specified
$135,000 - $216,000
Job Description
About Peraton
Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees solve the most daunting challenges that our customers face. Visit peraton.com to learn how we're keeping people around the world safe and secure.
About The Role
Position Overview
Peraton is seeking an experienced Technical Project Manager to support the CMS ClaimsCore modernization program. The successful candidate will combine strong technical program leadership with deep systems-integration experience and practical knowledge of Medicare claims processing, shared services, beneficiary data, eligibility, interfaces, and data migration.
This individual will provide technical leadership across ClaimsCore integration, migration, interface planning, and claims-processing activities as the program transitions from Proof of Concept (PoC) into production implementation. The role operates at the intersection of Medicare business operations, claims adjudication, systems engineering, data flows, interfaces, and program execution.
The candidate must be technically conversant and able to translate complex Medicare operational and technical requirements-including beneficiary/eligibility dependencies, provider data, historical claims information, and EDI/X12 transaction flows-into executable plans. The TPM will coordinate teams across Peraton, CMS, MACs, Cognizant/Facets, federal partners, and supporting vendors, ensuring alignment across integration, testing, cutover, and production-readiness activities.
The TPM is expected to identify cross-system dependencies, resolve technical issues and integration blockers, support interface discovery and specification development, and lead production workstream execution through implementation waves, cutover, onboarding, and stabilization.
Key Responsibilities
• Lead complex technical initiatives involving systems integration, data migration, claims-processing capabilities, and Medicare shared services.
• Develop and manage integrated implementation plans covering interfaces, data flows, configuration, testing, operational readiness, and production transition.
• Coordinate technical activities across application development, integration, infrastructure, security, data, testing, and business teams.
• Lead interface discovery and planning activities, including current-state analysis, requirements, ICD/spec development, testing, certification, cutover, and production readiness.
• Work with CMS, MACs, and SMEs to understand beneficiary, eligibility, provider, claims history, claim-status, adjudication, and pricing/editing dependencies.
• Lead complex data-migration activities including source-system analysis, mapping, transformation, reconciliation, historical-data use, data quality, and migration validation.
• Ensure migration/integration designs incorporate historical claims information, accumulators, beneficiary/eligibility attributes, and provider data required to process future claims.
• Coordinate implementation planning with ClaimsCore adjudication services and CMS shared services (e.g., CWF, PECOS, HIGLAS, pricing/editing services).
• Drive resolution of cross-team dependencies, technical issues, architectural decisions, risks, and implementation blockers.
• Develop executive-level status updates, recommendations, risk assessments, and implementation-readiness materials.
• Support production planning including MAC onboarding, phased implementation waves, cutover, operational readiness, and stabilization.
• Define measurable entry/exit criteria and completion evidence for major implementation milestones.
• Facilitate technical working sessions with CMS, MACs, vendors, and engineering teams, translating discussions into clear decisions and accountable actions.
• Provide leadership to multidisciplinary teams and assume responsibility for a major ClaimsCore production workstream.
Qualifications
Required Qualifications
Details
Target Salary Range: $135,000 - $216,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual's experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.
Benefits Statement: Peraton offers eligible employees a variety of benefits including medical, dental, vision, life, health savings account, short/long term disability, EAP, parental leave, 401(k), paid time off (PTO) for vacation, and company paid holidays. A full listing of available benefits can be viewed at https://www.careers.peraton.com/benefits.
Application Statements: The application period for the job is estimated to be 30 days from the job posting date. However, this timeline may be shortened or extended depending on business needs and the availability of qualified candidates. By applying to this job, you are expressing interest in the role and the Company. During the review of your application, you may be required to participate in an on-camera interview, as well as participate in a process to verify your identity. Use of artificial intelligence (AI) tools of any kind during Peraton interviews is strictly prohibited unless the candidate has obtained prior written authorization. All interview responses must be the candidate's own.
EEO:Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.
Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world's leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees solve the most daunting challenges that our customers face. Visit peraton.com to learn how we're keeping people around the world safe and secure.
About The Role
Position Overview
Peraton is seeking an experienced Technical Project Manager to support the CMS ClaimsCore modernization program. The successful candidate will combine strong technical program leadership with deep systems-integration experience and practical knowledge of Medicare claims processing, shared services, beneficiary data, eligibility, interfaces, and data migration.
This individual will provide technical leadership across ClaimsCore integration, migration, interface planning, and claims-processing activities as the program transitions from Proof of Concept (PoC) into production implementation. The role operates at the intersection of Medicare business operations, claims adjudication, systems engineering, data flows, interfaces, and program execution.
The candidate must be technically conversant and able to translate complex Medicare operational and technical requirements-including beneficiary/eligibility dependencies, provider data, historical claims information, and EDI/X12 transaction flows-into executable plans. The TPM will coordinate teams across Peraton, CMS, MACs, Cognizant/Facets, federal partners, and supporting vendors, ensuring alignment across integration, testing, cutover, and production-readiness activities.
The TPM is expected to identify cross-system dependencies, resolve technical issues and integration blockers, support interface discovery and specification development, and lead production workstream execution through implementation waves, cutover, onboarding, and stabilization.
Key Responsibilities
• Lead complex technical initiatives involving systems integration, data migration, claims-processing capabilities, and Medicare shared services.
• Develop and manage integrated implementation plans covering interfaces, data flows, configuration, testing, operational readiness, and production transition.
• Coordinate technical activities across application development, integration, infrastructure, security, data, testing, and business teams.
• Lead interface discovery and planning activities, including current-state analysis, requirements, ICD/spec development, testing, certification, cutover, and production readiness.
• Work with CMS, MACs, and SMEs to understand beneficiary, eligibility, provider, claims history, claim-status, adjudication, and pricing/editing dependencies.
• Lead complex data-migration activities including source-system analysis, mapping, transformation, reconciliation, historical-data use, data quality, and migration validation.
• Ensure migration/integration designs incorporate historical claims information, accumulators, beneficiary/eligibility attributes, and provider data required to process future claims.
• Coordinate implementation planning with ClaimsCore adjudication services and CMS shared services (e.g., CWF, PECOS, HIGLAS, pricing/editing services).
• Drive resolution of cross-team dependencies, technical issues, architectural decisions, risks, and implementation blockers.
• Develop executive-level status updates, recommendations, risk assessments, and implementation-readiness materials.
• Support production planning including MAC onboarding, phased implementation waves, cutover, operational readiness, and stabilization.
• Define measurable entry/exit criteria and completion evidence for major implementation milestones.
• Facilitate technical working sessions with CMS, MACs, vendors, and engineering teams, translating discussions into clear decisions and accountable actions.
• Provide leadership to multidisciplinary teams and assume responsibility for a major ClaimsCore production workstream.
Qualifications
Required Qualifications
- Bachelor's degree in IT, Computer Science, Engineering, Healthcare
- Administration, Business, or related field; equivalent relevant experience considered.
- 12+ years of progressively responsible technical project/program management experience in enterprise systems implementation.
- Demonstrated experience leading large-scale systems-integration initiatives involving APIs, EDI, batch/file, database, or multi-system connectivity.
- Demonstrated experience leading or coordinating large data migrations involving mission-critical systems.
- Healthcare payer or claims-processing experience, preferably with institutional and professional claims.
- Strong understanding of enterprise architectures, interfaces,
- ICDs/specifications, system dependencies, integration testing, and production cutover.
- Experience with interface inventories, dependency mapping, source-to-target data mapping, error-handling approaches, reconciliation, and operational support models.
- Experience managing multidisciplinary technical teams and coordinating with infrastructure, application, business, and vendor stakeholders.
- Experience developing integrated schedules, risk registers, dependency matrices, and executive-level reporting.
- Ability to communicate effectively with engineers, architects, SMEs, executives, government customers, and external partners.
- Ability to lead teams through ambiguity and develop actionable plans when requirements are evolving.
- Ability to obtain a Public Trust.
- US Citizen or a Green Card Holder.
- Experience working with Medicare Administrative Contractors and understanding MAC operational dependencies.
- Direct CMS or Medicare Fee-for-Service experience.
- Knowledge of CMS shared services such as CWF, PECOS, HIGLAS, pricing/editing services, eligibility/beneficiary services, claim-status services, and related interfaces.
- Experience with TriZetto Facets integrations or implementations.
- Experience migrating from legacy claims-processing systems to modern platforms, including interface transition and production cutover.
- Experience with X12 healthcare transactions including 837, 835, 270/271, and 276/277.
- Experience with API-led, hybrid-cloud, or AWS-based integration architectures.
- Experience supporting or leading production deployments, phased migrations, MAC onboarding, and post-implementation stabilization.
- PMP, SAFe, Agile, or similar program-management certification.
- Experience in large federal healthcare modernization programs.
Details
Target Salary Range: $135,000 - $216,000. This represents the typical salary range for this position. Salary is determined by various factors, including but not limited to, the scope and responsibilities of the position, the individual's experience, education, knowledge, skills, and competencies, as well as geographic location and business and contract considerations. Depending on the position, employees may be eligible for overtime, shift differential, and a discretionary bonus in addition to base pay.
Benefits Statement: Peraton offers eligible employees a variety of benefits including medical, dental, vision, life, health savings account, short/long term disability, EAP, parental leave, 401(k), paid time off (PTO) for vacation, and company paid holidays. A full listing of available benefits can be viewed at https://www.careers.peraton.com/benefits.
Application Statements: The application period for the job is estimated to be 30 days from the job posting date. However, this timeline may be shortened or extended depending on business needs and the availability of qualified candidates. By applying to this job, you are expressing interest in the role and the Company. During the review of your application, you may be required to participate in an on-camera interview, as well as participate in a process to verify your identity. Use of artificial intelligence (AI) tools of any kind during Peraton interviews is strictly prohibited unless the candidate has obtained prior written authorization. All interview responses must be the candidate's own.
EEO:Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.
group id: 91005870
