Product Manager, QNXT Implementation - SCAN Temp

SCAN Health Insurance • Long Beach, CA

1d • $34 - $50 • Remote

About The Position

The Product Manager, QNXT Implementation - SCAN Temp is responsible for designing and optimizing future state business requirements, workflows, and operating approaches for the Claims workstream as part of the QNXT implementation. This role partners closely with program managers supporting Claims, Provider Data, and Configuration, including provider contracts, benefits, UM/business rules, and capitation, as well as the program lead and subject matter experts, to define an end-to-end solution that is effective, efficient, scalable, and aligned to enterprise goals. The role is accountable for ensuring future state design decisions are not constrained by current processes, for coaching SMEs and product owners toward best-practice thinking, and for driving design outcomes that enable successful configuration, testing, readiness, and long-term operational performance.

Requirements

• Bachelor’s degree or equivalent combination of education and experience in Business, Health Administration, Information Systems, or related fields.
• Minimum 6 years related experience as a Product Manager with in the health plan, healthcare, or related industry.
• Strong knowledge of healthcare payer claims operations, including end-to-end claims workflows, adjudication logic, pricing, payment, exception handling, and operational dependencies.
• Demonstrated ability to design future state requirements, workflows, and business processes for complex system implementations or operating model transformations.
• Working knowledge of QNXT or similar core administrative platforms and the interaction between claims and related domains such as provider data, provider contracts, benefits, UM/business rules, and capitation.
• Ability to facilitate cross-functional workshops, synthesize input from multiple stakeholders, and translate business needs into clear, actionable requirements and workflow documentation.
• Strong coaching and influencing skills, with the ability to guide SMEs and product owners beyond current state thinking and toward efficient, scalable, and sustainable future state solutions.
• Ability to identify design tradeoffs, process inefficiencies, and cross-workstream dependencies, and recommend solutions that optimize end-to-end business and system performance.
• Strong analytical, organizational, and documentation skills, including the ability to maintain requirements, process maps, decisions, and design artifacts with a high degree of quality and traceability.
• Excellent verbal and written communication skills, with the ability to present complex design concepts, recommendations, and decisions clearly to leadership, operational teams, and technical stakeholders.
• Ability to support downstream implementation activities by ensuring future state designs are practical, testable, configurable, and aligned to operational readiness and go-live needs.
• Strong accountability and results orientation, with commitment to ensuring the Claims future state design delivers an effective, efficient, and scalable foundation for QNXT implementation success.
• Future state design, product management leadership experience.
• Systems thinking and end-to-end process optimization.
• Requirements elicitation and workflow design.
• Facilitation, influence, and stakeholder alignment.
• Coaching and challenging current state thinking.
• Analytical problem solving and decision making.
• Change leadership and continuous improvement mindset.
• Cross-functional collaboration and partnership.
• Accountability for design quality and business outcomes.
• Advanced Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams, Access), Visio, and SQL required.

Nice To Haves

• Master’s degree (preferred) - MBA, MPH, MS in Health Administration, Information Systems, or related field.
• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Responsibilities

• Lead the design of future state business requirements, workflows, and operational processes for the Claims workstream within the QNXT implementation, ensuring alignment to business objectives, system capabilities, and enterprise transformation goals.
• Define and document end-to-end future state workflows for claims processing, adjudication, pricing, exception handling, and related operational activities, with clear traceability to business requirements, decisions, and downstream implementation needs.
• Partner with program managers supporting Claims, Provider Data, and Configuration, including provider contracts, benefits, UM/business rules, and capitation, to ensure future state design decisions support an integrated end-to-end claims solution.
• Facilitate workshops and working sessions with SMEs, product owners, operational leaders, and technical partners to elicit requirements, challenge assumptions, evaluate options, and drive sound future state design decisions.
• Coach SMEs and product owners to think beyond current state processes and legacy system constraints, promoting best-practice design principles and ensuring the future state reflects the most effective and efficient operating model possible.
• Serve as a key design authority for the Claims workstream by identifying process improvement opportunities, resolving design tradeoffs, surfacing risks and dependencies, and driving decisions that optimize system performance, usability, and operational outcomes.
• Translate future state workflows and requirements into clear design artifacts and implementation inputs that support configuration, test scenario development, training, operational readiness, and go-live preparation.
• Work closely with the program lead and other cross-functional stakeholders to maintain alignment on scope, priorities, dependencies, and decisions impacting the future state design of claims-related capabilities.
• Ensure future state design deliverables are complete, high quality, and actionable, including requirements, workflow documentation, decision logs, process maps, design principles, and supporting materials for implementation teams.
• Hold accountability for the overall quality and effectiveness of the Claims future state design, ensuring the solution enables efficient operations, supports business readiness, and establishes a scalable foundation for long-term success in QNXT.
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Benefits

• Medical Benefits
• Paid Sick Time
• Excellent 401(k) Retirement Saving Plan
• Robust employee recognition program
• An opportunity to become part of a team that makes a difference to our members and our community every day!
• A competitive compensation and benefits program
• An annual employee bonus program
• Generous paid-time-off (PTO)
• Eleven paid holidays per year
• Excellent Retirement Savings program
• A work-life balance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level