Product Manager, QNXT Implementation - SCAN Temp
SCAN Health PlanAbout the role
Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.
Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.
Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.
At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.
The Job
The Product Manager, QNXT Implementation - SCAN Temp is responsible for designing and optimizing future state business requirements, workflows, and operating approaches for the Claims workstream as part of the QNXT implementation. This role partners closely with program managers supporting Claims, Provider Data, and Configuration, including provider contracts, benefits, UM/business rules, and capitation, as well as the program lead and subject matter experts, to define an end-to-end solution that is effective, efficient, scalable, and aligned to enterprise goals.
The role is accountable for ensuring future state design decisions are not constrained by current processes, for coaching SMEs and product owners toward best-practice thinking, and for driving design outcomes that enable successful configuration, testing, readiness, and long-term operational performance
You Will
Lead the design of future state business requirements, workflows, and operational processes for the Claims workstream within the QNXT implementation, ensuring alignment to business objectives, system capabilities, and enterprise transformation goals. Define and document end-to-end future state workflows for claims processing, adjudication, pricing, exception handling, and related operational activities, with clear traceability to business requirements, decisions, and downstream implementation needs.
Partner with program managers supporting Claims, Provider Data, and Configuration, including provider contracts, benefits, UM/business rules, and capitation, to ensure future state design decisions support an integrated end-to-end claims solution.
Facilitate workshops and working sessions with SMEs, product owners, operational leaders, and technical partners to elicit requirements, challenge assumptions, evaluate options, and drive sound future state design decisions.
Coach SMEs and product owners to think beyond current state processes and legacy system constraints, promoting best-practice design principles and ensuring the future state reflects the most effective and efficient operating model possible.
Serve as a key design authority for the Claims workstream by identifying process improvement opportunities, resolving design tradeoffs, surfacing risks and dependencies, and driving decisions that optimize system performance, usability, and operational outcomes.
Translate future state workflows and requirements into clear design artifacts and implementation inputs that support configuration, test scenario development, training, operational readiness, and go-live preparation.
Work closely with the program lead and other cross-functional stakeholders to maintain alignment on scope, priorities, dependencies, and decisions impacting the future state design of claims-related capabilities.
Ensure future state design deliverables are complete, high quality, and actionable, including requirements, workflow documentation, decision logs, process maps, design principles, and supporting materials for implementation teams.
Hold accountability for the overall quality and effectiveness of the Claims future state design, ensuring the solution enables efficient operations, supports business readiness, and establishes a scalable foundation for long-term success in QNXT.
We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
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