Project Manager - TPA

CV Resources has partnered with a Third-Party Administrator (TPA) in Greenville, SC to find an experienced Project Manager with a strong understanding of the Third-Party Administrator (TPA) environment. This role will oversee client implementations, operational initiatives, and cross-functional projects to ensure successful delivery of TPA services including claims administration, eligibility, and vendor integrations.

This is not a general PM role — candidates must understand how a TPA operates and be able to navigate claims, eligibility, funding, and client expectations. Key Responsibilities
Project & Implementation Management

• Lead new client implementations from onboarding through go-live (eligibility, plan setup, funding, reporting, etc.)
• Develop and manage project timelines, deliverables, and internal accountability
• Coordinate across internal teams (claims, eligibility, IT, client services) to ensure readiness
• Oversee vendor integrations (PBM, networks, telehealth, etc.)

Operational Oversight

• Ensure projects translate into smooth day-to-day operations post go-live
• Identify gaps in processes, workflows, or handoffs and drive improvements
• Monitor service expectations including turnaround times, accuracy, and SLAs
• Support ongoing operational initiatives and system enhancements

Client & Stakeholder Management

• Serve as a primary point of contact during implementation and major initiatives
• Run status calls and maintain clear communication with clients and internal teams
• Manage escalations and ensure timely resolution of issues
• Align expectations around scope, timelines, and deliverables

TPA-Specific Coordination

• Work closely with claims and eligibility teams to ensure proper setup and administration
• Coordinate plan designs, benefit structures, and funding arrangements
• Understand and support compliance-related components (ASA agreements, plan requirements, reporting)
• Partner on reporting, analytics, and performance tracking

Professional Communication & Documentation

• Create clear, professional client-facing communications including emails, letters, reports, and meeting summaries
• Maintain a high level of professionalism in all written and verbal communication
• Document project plans, decisions, and processes in a clear and structured way
• Develop and maintain SOPs for repeatable workflows

Requirements
Experience

• 2-5+ years of experience in a TPA, insurance carrier, or health plan environment
• Direct experience with claims administration, eligibility, or account management strongly preferred
• Proven experience managing implementations or operational projects

Knowledge

• Strong understanding of TPA operations (claims processing, eligibility, funding, vendors, etc.)
• Familiarity with benefit plans (medical, ancillary, or self-funded arrangements)
• Experience working with PBMs, provider networks, or third-party vendors is a plus

Skills

• Professional office presence with the ability to communicate clearly and effectively with clients, vendors, and internal teams
• Strong written communication skills, including the ability to draft professional emails, letters, and documentation
• Advanced proficiency in Microsoft Office (Outlook, Excel, Word, PowerPoint, and Teams)
• Highly organized with strong project management and follow-through
• Ability to manage multiple projects and competing priorities
• Strong problem-solving skills with the ability to identify issues and drive solutions quickly

PandoLogic. , Location: Greenville, SC - 29603