Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world’s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees solve the most daunting challenges that our customers face. Visit peraton.com to learn how we’re keeping people around the world safe and secure.
Position Overview
Peraton is seeking an experienced Technical Project Manager to support the CMS ClaimsCore modernization program. The successful candidate will combine strong technical program leadership with deep systems‑integration experience and practical knowledge of Medicare claims processing, shared services, beneficiary data, eligibility, interfaces, and data migration.
This individual will provide technical leadership across ClaimsCore integration, migration, interface planning, and claims‑processing activities as the program transitions from Proof of Concept (PoC) into production implementation. The role operates at the intersection of Medicare business operations, claims adjudication, systems engineering, data flows, interfaces, and program execution.
The candidate must be technically conversant and able to translate complex Medicare operational and technical requirements—including beneficiary/eligibility dependencies, provider data, historical claims information, and EDI/X12 transaction flows—into executable plans. The TPM will coordinate teams across Peraton, CMS, MACs, Cognizant/Facets, federal partners, and supporting vendors, ensuring alignment across integration, testing, cutover, and production‑readiness activities.
The TPM is expected to identify cross‑system dependencies, resolve technical issues and integration blockers, support interface discovery and specification development, and lead production workstream execution through implementation waves, cutover, onboarding, and stabilization.
Key Responsibilities
• Lead complex technical initiatives involving systems integration, data migration, claims‑processing capabilities, and Medicare shared services.
• Develop and manage integrated implementation plans covering interfaces, data flows, configuration, testing, operational readiness, and production transition.
• Coordinate technical activities across application development, integration, infrastructure, security, data, testing, and business teams.
• Lead interface discovery and planning activities, including current‑state analysis, requirements, ICD/spec development, testing, certification, cutover, and production readiness.
• Work with CMS, MACs, and SMEs to understand beneficiary, eligibility, provider, claims history, claim‑status, adjudication, and pricing/editing dependencies.
• Lead complex data‑migration activities including source‑system analysis, mapping, transformation, reconciliation, historical‑data use, data quality, and migration validation.
• Ensure migration/integration designs incorporate historical claims information, accumulators, beneficiary/eligibility attributes, and provider data required to process future claims.
• Coordinate implementation planning with ClaimsCore adjudication services and CMS shared services (e.g., CWF, PECOS, HIGLAS, pricing/editing services).
• Drive resolution of cross‑team dependencies, technical issues, architectural decisions, risks, and implementation blockers.
• Develop executive‑level status updates, recommendations, risk assessments, and implementation‑readiness materials.
• Support production planning including MAC onboarding, phased implementation waves, cutover, operational readiness, and stabilization.
• Define measurable entry/exit criteria and completion evidence for major implementation milestones.
• Facilitate technical working sessions with CMS, MACs, vendors, and engineering teams, translating discussions into clear decisions and accountable actions.
• Provide leadership to multidisciplinary teams and assume responsibility for a major ClaimsCore production workstream.
Required Qualifications
Highly Preferred Qualifications
EEO: Equal opportunity employer, including disability and protected veterans, or other characteristics protected by law.
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