TPA core services Requirements & Testing Lead

Posted 7 Hours Ago
Be an Early Applicant
Hiring Remotely in United States
Remote
113K-138K Annually
Senior level
Aerospace • Information Technology • Professional Services • Security • Software
The Role
Leads end-to-end healthcare TPA process governance, operational readiness, requirements coordination, testing alignment, and validation. Develops SOPs, workflow maps, RACI charts, decision trees, and governance frameworks across eligibility, claims, provider management, member services, appeals, payments, and integrations. Maintains traceability among processes, requirements, configurations, and testing artifacts while ensuring HIPAA, PHI/PII, federal compliance, and contract obligations. Monitors KPIs, audits, and quality controls and coordinates cross-functional corrective actions.
Summary Generated by Built In

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

MBI (T2)

Job Family:

Process and Operational Efficiency

Job Qualifications:

Skills:

Business Processes, Business Process Improvements, Process Analysis, Process Governance, Process Improvements

Certifications:

None

Experience:

5 + years of related experience

US Citizenship Required:

No

Job Description:

BUSINESS PROCESS MANAGER

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 longterm operations for the World Trade Center (WTC) Health Program. 

MEANINGFUL WORK AND PERSONAL IMPACT

This hybrid role combines business process ownership with requirements and testing leadership for core TPA services. The manager will lead endtoend 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 crosssystem 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 TransitionIn and steadystate delivery. 

Process Governance & Operational Leadership 

  • Develop, maintain, and govern endtoend 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 TransitionIn, 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 processrelated requirements and ensure they align with federal program rules, HIPAA, PHI/PII security, and contract obligations. 

WHAT YOU’LL NEED TO SUCCEED
Bring your initiative and drive for innovation to GDIT. The Business Process Manager must have:
● Education: Bachelor of Arts/Bachelor of Science
● Experience: 5+ years of related experience
● Security clearance level: MBT2
● Role requirements:

  • 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. 

GDIT IS YOUR PLACE
At GDIT, the mission is our purpose, and our people are at the center of everything we do.
● Growth: AI-powered career tool that identifies career steps and learning opportunities
● Support: An internal mobility team focused on helping you achieve your career goals
● Rewards: Comprehensive benefits and wellness packages, 401K with company match, and competitive pay and paid time off
● Flexibility: Full-flex work week to own your priorities at work and at home
● Community: Award-winning culture of innovation and a military-friendly workplace
OWN YOUR OPPORTUNITY
Explore a career in program management at GDIT and you’ll find endless opportunities to grow alongside colleagues who share your passion for the mission and delivering results.

The likely salary range for this position is $112,840 - $138,000. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours:

40

Travel Required:

Less than 10%

Telecommuting Options:

Remote

Work Location:

Any Location / Remote

Additional Work Locations:

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 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. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. GDIT typically provides new employees with 15 days of paid leave per calendar year to be used for vacations, personal business, and illness and an additional 10 paid holidays per year. Paid leave and paid holidays are prorated based on the employee’s date of hire. The GDIT Paid Family Leave program provides a total of up to 160 hours of paid leave in a rolling 12 month period for eligible employees. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

 



Our Identity Verification Process:

As part of the hiring process, we will ask you to complete an identity verification process that leverages advanced biometrics and artificial intelligence to ensure authenticity and protect against identity fraud. You are expected to be on camera during virtual interviews. We reserve the right to take your picture to verify your identity and prevent fraud. By proceeding, you authorize the collection, processing, and use of your biometric data for identity verification and security purposes.

About Our Work:

We are GDIT. A global technology and professional services company that delivers technology solutions and mission services to every major agency across the U.S. government, defense and intelligence community. Our 26,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50+ countries worldwide, offering leading mission-ready capabilities in AI, cloud, cyber and software development.

Join our Talent Community to stay up to date on our career opportunities and events at

gdit.com/tc.

Equal Opportunity Employer / Individuals with Disabilities / Protected Veterans

Skills Required

  • Bachelor of Arts or Bachelor of Science degree
  • 5+ years of related experience
  • MBI T2 security/background designation
  • Understanding of healthcare workflows, including eligibility verification, provider management, claims processing, payments, and appeals
  • Experience developing SOPs, process maps, BPMN artifacts, governance documents, and operational readiness frameworks
  • Proficiency with Visio, Lucidchart, Miro, or BPMN process-modeling tools
  • Familiarity with HIPAA, PHI/PII secure handling, and federal program compliance requirements
  • Experience coordinating cross-functional technical, operational, and program teams
  • Strong analytical, documentation, and communication skills

General Dynamics Information Technology Compensation & Benefits Highlights

The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about General Dynamics Information Technology and has not been reviewed or approved by General Dynamics Information Technology.

  • Affordable Benefits Pay and benefits are described as good or okay in multiple places, and the overall package is often portrayed as acceptable even when base pay is not viewed as top-tier.
  • Healthcare Strength Medical, dental, and vision plan options are presented as comprehensive, with additional protections like disability and life insurance contributing to a well-rounded health and protection offering.
  • Retirement Support A 401(k) plan with company match is consistently highlighted as part of the total rewards package, supporting longer-term financial planning.

General Dynamics Information Technology Insights

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The Company
HQ: Falls Church, VA
21,625 Employees

What We Do

We are GDIT. The people supporting some of the most complex government, defense, and intelligence projects across the country. We deliver. Bringing the expertise needed to understand and advance critical missions. We transform. Shifting the ways clients invest in, integrate, and innovate technology solutions. We ensure today is safe and tomorrow is smarter. We are there. On the ground, beside our clients, in the lab, and everywhere in between. Offering the technology transformations, strategy, and mission services needed to get the job done.

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