TPA core services Requirements & Testing Lead

General Dynamics Information Technology, Inc.

$112K — $138K *
US-AnywhereRemote in United States
Healthcare
5 - 7 years of experience
Job Overview by Ladders

Qualifications

  • 5+ years of related experience in operational processes
  • Expertise in healthcare workflows (eligibility, claims, provider management)
  • Proficiency in process documentation tools (Visio, Lucidchart, BPMN)
  • Knowledge of HIPAA, PHI/PII compliance requirements
  • Strong analytical and communication skills
  • Bachelor's degree in a relevant field

Responsibilities

  • Lead end-to-end operational process design and governance
  • Establish operational SOPs, workflow maps, and decision trees
  • Monitor operational performance using KPIs and audits
  • Coordinate requirements for TPA operational capabilities
  • Work with Business Analysts to validate requirements against processes
  • Maintain traceability between business processes and testing artifacts

Benefits

  • Comprehensive medical, dental, and vision plans
  • 401(k) with a company match
  • Flexible work schedule with remote options
  • Generous paid time off including vacation and holiday
  • Paid parental and family leave options
  • Short and long-term disability benefits
Full Job Description

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 andlongadtermoperations 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 leadendadtoadendoperational process design,admaintaingovernance frameworks, and oversee coordination of requirements, testing readiness, and validation activities across eligibility, claims workflows, provider management, member services, andadcrossadsystemintegrations.You will ensure TPA processes are documented, compliant, efficient, and performing at required levels adwhile also driving structured requirements oversight, test alignment, and operational readiness throughoutadTransitionadInad andadsteadyadstateaddelivery. ad

Process Governance & Operational Leadership

  • Develop,maintain, and governendadtoadendbusiness 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 duringTransitionadIn, ensuring staffing models, workflows, system dependencies, and controls are documented,validated, and prepared for launch.admonitor operational performance using KPIs, dashboards, quality checks, and audits;initiatecorrective 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 tovalidatethat 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 foradprocessadrelatedad requirements and ensure they align with federal program rules, HIPAA, PHI/PII security, and contract obligations. ad



WHAT YOU92LL NEED TO SUCCEED
Bring your initiative and drive for innovation to GDIT. The Business Process Manager must have:
6 Education: Bachelor of Arts/Bachelor of Science
6 Experience: 5+ years of related experience
6 Security clearance level: MBT2
6 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.

  • Proficiencywith Visio,a0Lucidchart, Miro, or BPMN tools for process modeling.
    Familiarity with HIPAA, PHI/PII secure handling, and federal program compliance requirements. ad

  • Experience coordinating cross-functional teams across technical, operational, and program areas.

  • Strong analytical, documentation, and communication skills.
    Bachelor92s degreea0required.a0


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 employee92s 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.

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