TPA core services Requirements & Testing Lead

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 and long‑term operations 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 lead end‑to‑end operational process design, maintain governance frameworks, and oversee coordination of requirements, testing readiness, and validation activities across eligibility, claims workflows, provider management, member services, and cross‑system integrations.  You will ensure TPA processes are documented, compliant, efficient, and performing at required levels — while also driving structured requirements oversight, test alignment, and operational readiness throughout Transition‑In and steady‑state delivery. 

Process Governance & Operational Leadership 

• Develop, maintain, and govern end‑to‑end business 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 during Transition‑In, ensuring staffing models, workflows, system dependencies, and controls are documented, validated, and prepared for launch. monitor operational performance using KPIs, dashboards, quality checks, and audits; initiate corrective 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 to validate that 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 for process‑related requirements and ensure they align with federal program rules, HIPAA, PHI/PII security, and contract obligations. 

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

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

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

• Strong analytical, documentation, and communication skills. 
  Bachelor’s degree required. 

GDIT IS YOUR PLACE
At GDIT, the mission is our purpose, and our people are at the center of everything we do.
● Growth: AI-powered career tool that identifies career steps and learning opportunities
● Support: An internal mobility team focused on helping you achieve your career goals
● Rewards: Comprehensive benefits and wellness packages, 401K with company match, and competitive pay and paid time off
● Flexibility: Full-flex work week to own your priorities at work and at home
● Community: Award-winning culture of innovation and a military-friendly workplace

OWN YOUR OPPORTUNITY
Explore a career in program management at GDIT and you’ll find endless opportunities to grow alongside colleagues who share your passion for the mission and delivering results.