Manager, Project Management - Medicare Reporting and Analytics

Position Summary

The Project Manager (PM) leads delivery of complex, data-driven initiatives supporting Medicare supplemental benefit programs and enterprise eligibility platforms.

This role operates at the intersection of business program requirements, data processing, and system integration, translating regulatory and business needs into scalable solutions that support member eligibility determination, enrollment processes, and downstream reporting.

The PM coordinates efforts across business, product, and technology teams to deliver solutions that:

• Process and integrate multiple data sources (e.g., claims, clinical, enrollment, and external inputs)
• Support eligibility determination and enrollment workflows
• Generate standardized outputs for internal stakeholders and external partners
• Maintain data integrity, traceability, and audit readiness in a regulated environment

The role also benefits from a working knowledge of enterprise data platforms (e.g., GCP/BigQuery) and the ability to perform targeted data analysis to support requirements validation, issue triage, and operational decision-making.

This position requires a strong ability to navigate ambiguity, connect business intent to technical execution, and manage interdependencies across interconnected platforms, while ensuring alignment with CMS and enterprise standards.

Primary Duties & Responsibilities

What You’ll Do

• Lead end-to-end delivery of initiatives involving data processing, eligibility and enrollment workflows, and reporting solutions

• Partner with business and technical teams to translate requirements into structured plans, functional requirements, and testable deliverables

• Drive coordination across teams to ensure successful implementation and a smooth transition to operations

• Drive User Acceptance Testing (UAT) to validate system behavior, data outputs, and operational readiness

• Lead data validation and reconciliation activities to ensure consistency across source systems and downstream platforms

• Perform or support targeted data analysis using SQL or similar tools to validate requirements, investigate issues, and support operational decision-making

• Support implementation and production readiness, including transition to operations, issue triage, and post-release monitoring

• Ensure documentation, processes, and deliverables meet regulatory, compliance, and quality standards

• Act as the central point of coordination across stakeholders, managing scope, risks, dependencies, and delivery timelines

• Identify and drive improvements to data quality, workflow efficiency, and delivery practices

• Promote Agile and hybrid methodologies where applicable

• Identify opportunities to streamline operations, improve data quality, and enhance automation

What You’ll Bring

• 5+ years of experience managing cross-functional projects in complex, matrixed environments

• Strong ability to collaborate across business and technical teams and drive alignment among diverse stakeholders

• Demonstrated ability to operate effectively in ambiguous environments, connecting disparate inputs to form clear, actionable plans

• Excellent communication skills, with the ability to provide clear and concise updates to both team members and leadership

• Proven track record of problem-solving, particularly in resolving data discrepancies and system-related issues

• Proficiency with Microsoft O365 tools (Excel, PowerPoint, Project) and collaboration platforms (Teams, Jira, etc.)

• Strong organizational skills and attention to detail, with a focus on delivering high-quality, audit-ready outputs

• Working knowledge of SQL and data querying concepts, with the ability to analyze datasets to support validation, testing, and issue investigation

Preferred Qualifications

• Experience in healthcare, insurance, or other regulated industries

• Experience with S19, SSBCI, or Medicare compliance programs

• Experience working with GCP, Oracle, and SQL Server databases

• Ability to write or modify SQL queries to support analysis, validation, and troubleshooting

• Experience supporting CMS audit readiness and regulatory compliance initiatives

• Experience with data reconciliation, UAT coordination, and production support processes

Education

Bachelor’s degree in Business, Information Systems, Healthcare, or a related field (or equivalent experience)