Data Governance & Ownership Senior Manager - Medicare Provider Data Quality & Accuracy

Cigna - Bloomfield, CT

Full-time - Mid Level

Hybrid - Bloomfield, CT

Insurance Carriers and Related Activities

About the position

The Data Governance & Ownership (DG&O) Senior Manager will collaborate closely with the Provider Data Quality & Accuracy (PDQA) Director to establish a robust framework and set of policies aimed at enhancing the quality and accuracy of provider data. This role is pivotal in ensuring that the organization meets specific goals and metrics as dictated by both business and regulatory requirements. The Senior Manager will lead a dedicated team of data stewards who are responsible for maintaining data lineage, documenting business rules, and ensuring the proper usage of each data element across various domains, including Credentialing, Directory, Reimbursement/Capitation, Configuration, and Network. In this position, the Senior Manager will coordinate and partner with key Medicare operations teams, such as claims, enrollment, fulfillment, network operations, and technology, to ensure the delivery of operational excellence. A critical aspect of this role involves monitoring provider data quality and accuracy, which is essential for maintaining CMS-compliant provider directories and improving claims auto-adjudication processes. The Senior Manager will champion incremental improvements within the Data Quality management process, focusing on measurable enhancements in data quality while understanding the business impacts and prioritizing necessary data quality remediation efforts. The Senior Manager will also work closely with product and process owners to create and implement comprehensive data governance frameworks, policies, and standards that ensure data quality and compliance. This includes efforts to eliminate non-value-added tasks by reducing unnecessary data entry and facilitating data sharing across systems. Additionally, the Senior Manager will oversee the management of data assets by the data stewards, support the development of quality metrics, and implement data cleansing and validation procedures to ensure data integrity and accuracy. Identifying and mitigating data-related risks will be a key responsibility, along with monitoring controls to safeguard data assets and ensure their proper usage. The Senior Manager will establish and track key performance indicators (KPIs) to measure the effectiveness of data governance initiatives and provide regular reports to senior management on the progress of these activities. Furthermore, this role involves attracting, recruiting, hiring, developing, mentoring, coaching, and retaining top talent to support the execution of the Medicare growth strategy.

Responsibilities

• Coordinate and partner with key Medicare operations teams to ensure operational excellence.
• Monitor provider data quality and accuracy to maintain CMS-compliant provider directories.
• Champion incremental improvements in the Data Quality management process.
• Partner with product/process owners to create and implement data governance frameworks and policies.
• Ensure data stewards effectively manage data assets.
• Support the development of quality metrics and monitoring processes for data integrity.
• Identify and mitigate data-related risks and monitor controls for data asset usage.
• Establish and track KPIs for data governance initiatives and report to senior management.
• Attract, recruit, hire, develop, mentor, and retain top talent.

Requirements

• Bachelor's degree in a relevant field.
• At least 5 years of experience in data governance or data management.
• Experience in healthcare and provider data management is strongly preferred.
• Demonstrated experience in leading and developing teams.
• Proficiency in SQL and experience mentoring others in SQL development.
• Familiarity with data governance tools and technologies is a plus.
• Certification in data management (e.g., CDMP, DGSP) is a plus.
• Strong analytical, synthesizing, and problem-solving skills.
• Ability to work at both conceptual and detailed levels.
• Willingness to share opinions and take risks.
• Experience with client-facing business units is preferred.
• Creative thinking and ability to translate strategies into actions.
• Strong organizational skills to manage multiple priorities simultaneously.
• Excellent written and oral communication skills.

Nice-to-haves

• Experience in a healthcare setting.
• Familiarity with data governance frameworks and best practices.
• Experience in managing remote teams.

Benefits

• Medical insurance
• Vision insurance
• Dental insurance
• Well-being and behavioral health programs
• 401(k) with company match
• Company paid life insurance
• Tuition reimbursement
• Minimum of 18 days of paid time off per year
• Paid holidays
• Annual bonus plan