The Role
Leads complex post-sale health plan implementations from kickoff through launch, stabilization, and operational handoff. Owns project plans, client relationships, cross-functional coordination, risks, decisions, testing, claims workflow validation, issue resolution, readiness, documentation, and executive reporting. The role requires direct payer implementation and healthcare claims experience, strong facilitation and communication skills, and the ability to drive accountability across teams. It also mentors junior staff and improves implementation processes, templates, and standards.
Summary Generated by Built In
Integra Partners is seeking an experienced Implementation Manager to lead complex, post-sale health plan implementations from initiation through operational handoff. This role owns the implementation plan, client relationship, cross-functional coordination, risks, decisions, and readiness activities required to deliver on time, within scope, and with a high-quality client experience. The successful candidate brings direct health plan implementation experience and practical knowledge of claims operations, testing, and issue resolution.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
PREFERRED QUALIFICATIONS:
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Independently leads complex implementations for health plan clients and healthcare partners, from kickoff and requirements validation through testing, launch, stabilization, and transition to operations.
- Build and maintain the integrated implementation project plan, work breakdown structure, milestones, dependencies, decision log, risk and issue log, and executive status reporting.
- Serve as the primary implementation point of contact for external clients and coordinate internal teams across operations, claims, technology, network, clinical, finance, compliance, and other functional areas.
- Translate contractual commitments, requirements, operational workflows, and technical specifications into clear implementation requirements, owners, due dates, acceptance criteria, and signoffs.
- Lead claims-related implementation activities, including workflow design, configuration validation, test scenario development, end-to-end claims testing, defect triage, reconciliation, and production readiness.
- Monitor timeline, scope, quality, budget, and resource needs; identify risks early and drive mitigation, escalation, and resolution with accountable owners.
- Facilitate internal and client-facing meetings, document outcomes, and communicate concise status summaries, recommendations, decisions, and next steps to project teams and senior leadership.
- Ensure implementation documentation is complete and audit-ready, including project plans, requirements, meeting materials, test evidence, approvals, lessons learned, and transition documentation.
- Apply a continuous-improvement mindset to simplify processes, strengthen controls, and improve implementation quality and repeatability.
- Mentor junior team members and contribute to implementation standards, templates, playbooks, and best practices.
REQUIRED QUALIFICATIONS:
- 5+ years of implementation, project management, client delivery, or related experience in healthcare, including direct responsibility for health plan or payer implementations.
- Demonstrated experience leading implementation work with health plans, including requirements, cross-functional readiness, client governance, testing, launch, and post-launch stabilization.
- Claims experience is required, with working knowledge of healthcare claims workflows, configuration, testing, adjudication outcomes, exception handling, reconciliation, and issue resolution.
- Experience managing multiple work-streams, dependencies, risks, and executive-level communications in a client-facing environment.
- Ability to understand complex healthcare, operational, and technical concepts and translate them into clear business language and executable plans.
- Strong facilitation, organization, documentation, analytical problem-solving, and written and verbal communication skills.
- Proficiency with standard project management and productivity tools; ability to quickly learn company systems and processes.
- Ability to exercise sound judgment, manage competing priorities, and drive accountability without direct authority.
PREFERRED QUALIFICATIONS:
- Experience with Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), including related benefits, provider or supplier workflows, claims, and operational considerations.
- Experience implementing network management, utilization management, provider network, or delegated services programs.
- Project management certification or formal project management methodology experience.
- Experience working in a highly regulated healthcare environment and handling confidential or sensitive information.
EDUCATION AND ADDITIONAL REQUIREMENTS:
SUCCESS IN THE ROLE:
First 6 months
- Bachelor's degree preferred, or equivalent combination of education and relevant experience.
- Willingness and ability to travel up to 35%, based on business and client needs.
SUCCESS IN THE ROLE:
First 6 months
- Develop a strong understanding of the role, departmental policies, implementation tools, and assigned client programs.
- Establish effective working relationships with client and internal stakeholders and independently manage core implementation routines.
- Set measurable professional development and delivery goals.
- Consistently lead complex health plan implementations with clear ownership, disciplined governance, and executive-ready communication.
- Demonstrate strong command of claims implementation dependencies and drive issues through resolution and stabilization.
- Contribute knowledge, templates, lessons learned, and process improvements that strengthen the implementation function.
Salary: $100,000.00/annually
Skills Required
- 5+ years of implementation, project management, client delivery, or related experience in healthcare, including direct responsibility for health plan or payer implementations
- Experience leading health plan implementation work involving requirements, cross-functional readiness, client governance, testing, launch, and post-launch stabilization
- Working knowledge of healthcare claims workflows, configuration, testing, adjudication outcomes, exception handling, reconciliation, and issue resolution
- Experience managing multiple workstreams, dependencies, risks, and executive-level communications in a client-facing environment
- Ability to understand complex healthcare, operational, and technical concepts and translate them into business language and executable plans
- Strong facilitation, organization, documentation, analytical problem-solving, and written and verbal communication skills
- Proficiency with standard project management and productivity tools, with ability to learn company systems and processes
- Ability to exercise sound judgment, manage competing priorities, and drive accountability without direct authority
- Experience with DMEPOS, including related benefits, provider or supplier workflows, claims, and operational considerations
- Experience implementing network management, utilization management, provider network, or delegated services programs
- Project management certification or formal project management methodology experience
- Experience working in a highly regulated healthcare environment and handling confidential or sensitive information
- Bachelor's degree or equivalent combination of education and relevant experience
- Willingness and ability to travel up to 35% based on business and client needs
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The Company
What We Do
Integra Partners is a leading network management company that connects Orthotics and Prosthetics (O&P) and Durable Medical Equipment (DME) providers with health plans and their patients. The company works with more than 50 health plans and has over 4,000 provider locations in its network. For more information on Integra Partners, visit www.accessintegra.com
