TPA core services Requirements & Testing Lead

General Dynamics Information Technology•USA GA Home Office (GAHOME), GA

1d•$112,840 - $138,000•Remote

About The Position

At GDIT, people are our differentiator. We are seeking a Business Process Manager / TPA Core Services Requirements & Testing Lead to support Third Party Administrator (TPA) healthcare implementation and long‑term operations for the World Trade Center (WTC) Health Program. This hybrid role combines business process ownership with requirements and testing leadership for core TPA services. The manager will lead end‑to‑end operational process design, maintain governance frameworks, and oversee coordination of requirements, testing readiness, and validation activities across eligibility, claims workflows, provider management, member services, and cross‑system integrations. You will ensure TPA processes are documented, compliant, efficient, and performing at required levels — while also driving structured requirements oversight, test alignment, and operational readiness throughout Transition‑In and steady‑state delivery.

Requirements

Bachelor of Arts/Bachelor of Science
5+ years of related experience
MBT2 security clearance level
Strong understanding of healthcare operational workflows including eligibility verification, provider management, claims processing, payments, and appeals.
Experience developing SOPs, process maps, BPMN artifacts, governance documents, and readiness frameworks.
Proficiency with Visio, Lucidchart, Miro, or BPMN tools for process modeling.
Familiarity with HIPAA, PHI/PII secure handling, and federal program compliance requirements.
Experience coordinating cross‑functional teams across technical, operational, and program areas.
Strong analytical, documentation, and communication skills.
Bachelor’s degree required.

Responsibilities

Develop, maintain, and govern end‑to‑end business processes for eligibility operations, claims lifecycle workflows, provider management, member services, appeals, payments, and issue resolution.
Establish operational SOPs, workflow maps, RACI charts, decision trees, and governance structures.
Oversee operational readiness activities during Transition‑In, ensuring staffing models, workflows, system dependencies, and controls are documented, validated, and prepared for launch.
Monitor operational performance using KPIs, dashboards, quality checks, and audits; initiate corrective actions as needed.
Lead requirements coordination for core TPA operational capabilities, ensuring alignment across eligibility, claims, provider data, and member engagement processes.
Work closely with Business Analysts to validate that requirements map correctly to real‑world business process needs.
Maintain traceability between business processes, requirements, SOPs, system configuration rules, and testing artifacts.
Oversee change control for process‑related requirements and ensure they align with federal program rules, HIPAA, PHI/PII security, and contract obligations.

Benefits

401K with company match
Competitive pay
Paid time off
Full flex work weeks
Variety of medical plan options
Health Savings Accounts
Dental plan options
Vision plan
401(k) plan offering the ability to contribute both pre and post‑tax dollars up to the IRS annual limits and receive a company match.
Variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave.
15 days of paid leave per calendar year to be used for vacations, personal business, and illness
10 paid holidays per year
Paid leave and paid holidays are prorated based on the employee’s date of hire.
Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees.
Short and long‑term disability benefits
Life insurance
Accidental death and dismemberment insurance
Personal accident insurance
Critical illness insurance
Business travel and accident insurance