Job Title: Project Manager - Data Governance (Healthcare Insurance)
Location: Philadelphia, PA
Job Type: Contract
Our client is seeking an experienced and strategic Project Manager with a strong background in data governance, Medicaid/Medicare analytics, and healthcare insurance systems to lead high-impact data and reporting initiatives across the organization. The ideal candidate will bring a hybrid skill set as a seasoned Project Manager and Product Owner, capable of driving cross-functional collaboration, enhancing data quality, and ensuring compliance within an agile environment.
Key Responsibilities:
- Lead end-to-end project management for enterprise data governance and analytics initiatives within healthcare insurance platforms, including Medicaid and Medicare claims and reporting systems.
- Drive process improvement, data quality enhancement, and automation strategies for data ingestion, ETL pipelines, and reporting workflows (e.g., using SAS, SQL, Alteryx).
- Oversee the planning, execution, and delivery of data-driven healthcare analytics solutions, including predictive models for risk stratification, care gap analysis, and population health.
- Manage stakeholder expectations and communication across clinical, business, and IT teams to ensure alignment with enterprise data governance goals.
- Develop and implement project plans, timelines, and work breakdown structures (WBS), ensuring adherence to compliance and security protocols (CMS, HIPAA).
- Facilitate Agile ceremonies including sprint planning, backlog grooming, and retrospectives using tools like Jira, Confluence, Asana, or MS Project.
- Design and present dashboards and executive reports via Tableau, Power BI, or other visualization tools to support strategic decision-making.
- Collaborate on CMS tool upgrades, Medicaid reporting enhancements, and care outreach platform improvements to optimize preventive care and operational efficiency.
Required Qualifications:
- 8+ years of professional experience in project or program management, with at least 5 years focused on data governance and healthcare insurance (Medicaid/Medicare).
- Proven experience in Agile and SAFe methodologies as a Project Manager or Product Owner.
- Strong technical proficiency in SQL, SAS, ETL, Tableau, Power BI, and data warehousing concepts (e.g., EDW, RDBMS).
- Demonstrated ability to lead cross-functional teams and translate complex business requirements into scalable data solutions.
- Expertise in regulatory healthcare reporting, risk mitigation, and compliance with CMS and state Medicaid guidelines.
- Familiarity with tools such as Jira, ServiceNow, Smartsheet, Lucidchart, and Microsoft Project.
- Strong communication, executive reporting, and stakeholder management skills.
Preferred Qualifications:
- Experience with predictive analytics or machine learning in a healthcare setting.
- Knowledge of CMS reporting standards, Medicaid encounter processing, and healthcare quality metrics.
- Certifications such as PMI-PMP, Certified Scrum Product Owner (CSPO), or IIBA Agile Product Owner.
- Six Sigma Black Belt or Master Black Belt certification is a plus.
- Advanced academic background (e.g., Master's or PhD in Information Systems, Healthcare IT, or Industrial Engineering).