Consulting Manager, Healthcare Project Manager

About Cognizant Consulting:

Cognizant Consulting is more than Cognizant’s consulting practice—we’re a global community of 6,000+ experts dedicated to helping clients reimagine their business. Blending our deep industry and technology advisory capability, we create innovative business solutions for Fortune 500 clients. And now, we’re looking for our next colleague who’ll join us in shaping the future of business. Could it be you?

As a Consulting Manager, Healthcare Business Transformation, you will make an impact by leading a comprehensive assessment of enterprise Long-Term Services and Supports (LTSS) operations, identifying opportunities to improve process efficiency, system interoperability, data integrity, and financial performance. You will be a valued member of the Healthcare Consulting team and work collaboratively with business stakeholders, LTSS operations teams, product owners, IT teams, architects, data analysts, finance leaders, and executive sponsors.

• Lead end-to-end assessment and documentation of LTSS business processes across authorization, claims, provider, member, and financial workflows.
• Analyze interactions between Pega, QNXT, and related healthcare platforms to identify process, integration, and data flow gaps.
• Evaluate authorization-to-claims transaction integrity, data mappings, and operational controls to identify root causes of processing issues and financial leakage.
• Facilitate stakeholder workshops, discovery sessions, and executive presentations to align business and technology teams on findings and recommendations.
• Develop actionable remediation roadmaps, business cases, risk assessments, and transformation strategies that improve operational performance and reduce business risk.

We strive to provide flexibility wherever possible. Based on this role’s business requirements, this is a remote position open to qualified applicants in the United States. Regardless of your working arrangement, we are here to support a healthy work-life balance though our various wellbeing programs.

The working arrangements for this role are accurate as of the date of posting. This may change based on the project you’re engaged in, as well as business and client requirements. Rest assured; we will always be clear about role expectations.

• Bachelor's degree or equivalent professional experience in Healthcare Administration, Information Systems, Business, or a related field.
• 8+ years of experience in healthcare consulting, business transformation, program management, or healthcare operations.
• Strong experience with QNXT and healthcare payer platforms, including claims, benefits, enrollments, and authorization workflows.
• Experience working with Pega-based healthcare workflows, care management, or authorization management processes.
• Proven expertise in healthcare process analysis, stakeholder management, business requirements, and current-state/future-state process mapping.
• Experience conducting system integration reviews, data lineage assessments, reconciliation analysis, and business impact evaluations.
• Strong communication and executive presentation skills with the ability to influence stakeholders across business and technology organizations.
• Experience creating executive-level deliverables, recommendations, remediation roadmaps, and transformation strategies.

• Experience supporting Molina Healthcare or other Medicaid and LTSS-focused healthcare organizations.
• Knowledge of healthcare claims processing, financial workflows, payment integrity, and leakage analysis.
• Experience leading enterprise assessments involving interoperability, data governance, and technology modernization…