Healthcare Claims Senior Manager

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

None

Job Family:

Healthcare Claims

Job Qualifications:

Skills:

Call Center, Deliverables Management, Leadership, People Management, Training

Certifications:

None

Experience:

5 + years of related experience

US Citizenship Required:

No

Job Description:

Healthcare Claims Sr Manager

Drive better health outcomes for our clients as a Healthcare Claims Sr Manager at GDIT. Here, your work will impact many as you deliver healthcare expertise and services where they are needed most. Own this opportunity to advance not just, patient outcomes, but also your personal career growth.

At GDIT, people are our differentiator. As a Healthcare Claims Sr Manager, you will help ensure today is safe and tomorrow is smarter. Our work depends on Healthcare Claims Sr Manager joining our team to manage staff and key deliverables to meet service agreements and consistently deliver high quality and timely service.

HOW A SENIOR MANAGER HEALTHCARE CLAIMS WILL MAKE AN IMPACT

• You will act as a thought partner to the leadership team to provide support and counsel for operations management, communications, initiatives and projects.
• You should be a self-starter with outstanding organization and communication skills, fast paced environment.
• Understand strategic financials regarding areas of oversight.
• Proven ability to build strong partnerships with colleagues, desire to be flexible and think proactively, strategically, and analytically about diverse business solutions and leading professional working groups.
• Ability to make critical decisions with limited guidance while ensuring visibility into those decisions.
• A demonstrated understanding of Medicaid support operations and an appreciation for how to prioritize among demands and balance the levers that make a complex business run smoothly and productively.
• Manages Provider Enrollment operations for NCMMIS program, including optimizing resources to facilitate SLA deliverables and maximize efficient operations.
• Manages change management efforts and reporting to optimize SLAs and ensure optimization of resources.
• Serve as lead cross departmental deliverables for operations, including internal and external audits, business continuity, and other program operations deliverables.
• Serve as a resource for operational managers and assist with training and mentoring operational managers regarding key operational processes.
• Lead cross departmental operational efforts for internal and external quality assessments, audits and surveys.
• Lead cross departmental communication initiatives to both internal and external stakeholders, including community engagement efforts and efforts to facilitate employee engagement.
• Manage and oversee key departments, including training and operational data efforts to optimize efficiencies and ensure effective operations.
• Oversee and coordinate NCQA CVO efforts and all supporting efforts.
• Manages and optimizes customer and key stakeholder relationships, including escalations and developing processes to facilitate timely management of provider enrollment related escalations.

WHAT YOU’LL NEED TO SUCCEED:

• Education: Bachelor's Degree in related technical, scientific, business, health or a related discipline
• Required Experience: 5+ years of related experience
• Required Skills and Abilities: Medicaid Operations Leadership Support , Project Management Skills, Provider Enrollment Management Skills and Experience, NCQA CVO knowledge and experience.
• Demonstrated ability to communicate issues, impacts, and corrective actions
• Demonstrated ability to easily and effectively communicate project topics to a diverse audience
• Demonstrated ability to clearly report relevant information
• Preferred Skills: SharePoint, Excel, PMO, PowerPoint
• Location: Hybrid
• US Citizenship Required

GDIT IS YOUR PLACE:

• 401K with company match
• Comprehensive health and wellness packages
• Internal mobility team dedicated to helping you own your career
• Professional growth opportunities including paid education and certifications
• Cutting-edge technology you can learn from
• Rest and recharge with paid vacation and holidays

The likely salary range for this position is $124,950 - $169,050. 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:

None

Telecommuting Options:

Hybrid

Work Location:

USA NC Raleigh

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. 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.

We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 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 capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

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

Client-provided location(s): Raleigh, NC

Job ID: 20648_RQ202570-2

Employment Type: FULL_TIME

Posted: 2025-07-22T00:00:00