Claims Project Manager

Claim Project Manager (Remote – EST Hours | Contract-to-Hire)Location: 100% Remote (Must work EST hours)Visa: No sponsorship availableAbout the RoleWe are seeking an experienced Claim Project Manager to support large-scale initiatives within the healthcare and insurance domain. This role requires a professional who can operate in both Project Manager and Scrum Master capacities while driving complex claims and adjudication projects across cross-functional teams.Successful candidates will bring hands-on experience with payer or PBM claims systems, strong communication skills, and the ability to manage both technical and business-facing workstreams.What You’ll DoLead end-to-end delivery of claims-focused projects (claims, adjudication, provider/member systems, enrollment).Serve in a dual role as both Project Manager and Scrum Master for Agile and hybrid initiatives.Manage budgets, including resource hours, SOWs, and cloud/infrastructure costs.Build and maintain project plans, roadmaps, timelines, dashboards, and executive reports.Drive platform modernization efforts and support transformation work across enterprise systems.Facilitate discussions between business, IT, vendors, and senior leadership.Provide consistent risk, issue, and status updates to stakeholders.Support Agile ceremonies, sprint planning, and cross-team coordination.Required Experience7+ years of experience in healthcare, insurance, or PBM project delivery.Strong background in claims, claim adjudication, or payer operations.Experience serving as both PM and Scrum Master.Familiarity with tools such as Jira, Clarity, RTC/RRC, SharePoint, QuickBase, and MS Office Suite.Experience leading Agile, Waterfall, and Hybrid projects.Strong executive communication and presentation skills.Preferred QualificationsBackground with claims technology platforms (e.g., Facets, QNXT, HealthRules, Edifecs, etc.).PMP, CSM, SAFe, or similar certifications.