Position OverviewPeraton 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.
QualificationsRequired 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.
Highly Preferred Qualifications
- 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.
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 do the can’t be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we’re keeping people around the world safe and secure.
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. EEOEEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.Skills Required
- Bachelor's degree in IT, Computer Science, Engineering, Healthcare Administration, Business, or a related field; equivalent relevant experience may be considered.
- 12+ years of progressively responsible technical project or program management experience in enterprise systems implementation.
- Experience leading large-scale systems integration initiatives involving APIs, EDI, batch/file, databases, or multi-system connectivity.
- 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, reconciliation, and operational support models.
- Experience managing multidisciplinary technical teams and coordinating 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, subject matter experts, executives, government customers, and external partners.
- Ability to lead teams through ambiguity and develop actionable plans as requirements evolve.
- Ability to obtain a Public Trust.
- US citizenship or Green Card holder status.
- 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, eligibility/beneficiary, and claim-status services.
- Experience with TriZetto Facets integrations or implementations.
- Experience migrating 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.
Peraton Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about Peraton and has not been reviewed or approved by Peraton.
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Healthcare Strength — Healthcare offerings are described as broad, including medical, dental, vision, mental health support, and specialty programs like virtual physical therapy and surgical/cancer care navigation. Medical coverage is also characterized as a standout part of the overall package in terms of perceived quality.
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Retirement Support — Retirement support includes a 401(k) with employer matching and is repeatedly positioned as a strong component of total rewards. The 401(k) benefit is frequently singled out as one of the most valued parts of the package.
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Leave & Time Off Breadth — Time-off benefits are positioned as robust, including PTO, holidays, paid sick days, and floating holidays, with some roles offering notably generous accrual. Leave breadth is reinforced by related programs such as short/long-term disability and bereavement leave.
Peraton Insights
What We Do
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 do the can’t be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we’re keeping people around the world safe and secure.
Why Work With Us
We are fearlessly solving the world’s most complex challenges to keep people safe and secure. You can be a part of protecting and promoting that freedom around the world.
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