Job Description

Project Manager – Claims Operations & TPA Integration

Employment Type: Contract

Workplace Type: Hybrid

Location: Purchase, NY

Compensation: $50/hr. - $70/hr.

Overview

TalentoHC has partnered with a global multi-billion-dollar enterprise in the insurance space seeking a Claims Project Manager to lead high-impact, end-to-end initiatives that strengthen the TPA ecosystem, modernize Claims operational workflows, and improve data quality across the organization. This role requires a seasoned PM with deep insurance/TPA experience, strong project governance skills, and the ability to operate in complex, data-driven environments involving Claims Operations, TPA partners, Data Engineering, Finance, Technology, and external vendors.

Qualifications

• Lead and manage multiple concurrent Claims and TPA integration projects from planning through execution and stabilization
• Establish structured project governance for multi-team programs across Claims, IT, Data Engineering, Finance, and vendor partners
• Manage TPA Data End-to-End Reconciliation, ensuring accuracy, consistency, and downstream alignment with systems including RSG
• Oversee RSG data aggregation redesign, improving ingestion, quality rules, and reporting structures
• Lead onboarding of new TPAs including workflow alignment, system integration, data mapping, feed validation, testing, and operational readiness
• Coordinate the build-out and standardization of data feeds for additional TPAs, including transformation rules and full UAT coverage
• Partner with Data Engineering and IT to ensure end-to-end data flow integrity, lineage completeness, and reconciliation controls
• Lead system testing across SIT, UAT, and cutover phases
• Interface with TPA partners to clarify requirements, align timelines, and track deliverables
• Facilitate working groups, steering committees, and executive-level reporting
• Ensure compliance with audit, regulatory, and data governance standards
• Collaborate with Change Management teams on training, communications, SOP updates, and readiness assessments
• Support rollout plans, process documentation, and hypercare activities

Requirements

• 10–15 years of experience in Project/Program Management (insurance or claims highly preferred)
• Strong understanding of TPA operations, claims workflows, and data integration
• Experience with Guidewire, RSG, Luminoso, data warehouses, or similar platforms
• Excellent communication, stakeholder management, and issue-resolution skills
• Strong analytical abilities and data mapping experience
• PMP, Scrum Master, or similar certification is a plus

About Talento Human Capital (TalentoHC):

TalentoHC is a leading talent acquisition, executive search, and human capital consulting partner, dedicated to helping our clients build their best teams yet. Our success is driven by our unwavering commitment to fostering an inclusive and diverse workforce, embracing individuals from various backgrounds, perspectives, and skills. Talento Human Capital is an equal opportunity employer.

People + Passion + Perseverance = Progress

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