Policy Enablement Workstream LeadLocation: Philadelphia, PA (Hybrid - Onsite Tuesday, Wednesday, Thursday)
Duration: 6-Month Contract with Potential for Conversion
Hours: Full-time (40 hours/week)
Schedule: 8:00 AM start (occasional evening/weekend support may be required)
OverviewOur client is seeking a Policy Enablement Workstream Lead to support a large-scale transformation initiative focused on migrating TPA clients to a new enterprise benefits and medical policy platform. This individual will play a critical role in coordinating policy implementation activities, managing project tracking, partnering with business and technical stakeholders, and ensuring successful client transitions through testing and deployment.
This role offers the opportunity to work on a multi-year enterprise program supporting client migrations through 2028 while collaborating with leadership, business teams, testing organizations, and offshore configuration teams.
Responsibilities- Manage the Policy Enablement implementation plan and transition tracker across multiple client migrations.
- Coordinate policy enablement activities from analysis through configuration, testing, and production readiness.
- Track client and benefit plan progress across customization analysis, configuration, independent validation and verification (IV&V), testing, and implementation.
- Partner with Sales and Account Management teams to review client-specific customizations and medical policy analysis.
- Coordinate with testing teams to review testing scenarios, analyze claim outcomes, and resolve policy-related issues.
- Maintain and govern the medical policy configuration inventory, including benefit limits, exclusions, precertification requirements, and other policy components.
- Manage customization analysis work plans and exception tracking.
- Coordinate work and priorities across onshore and offshore policy configuration teams.
- Support knowledge transfer efforts and provide guidance to offshore resources.
- Analyze claims data and policy trends to identify issues and support implementation decisions.
- Prepare executive-level status updates, project metrics, and leadership reporting.
- Ensure project documentation and tracking artifacts remain accurate and current.
- Collaborate across multiple workstreams in a fast-paced enterprise environment.
Required Qualifications- 2+ years of project coordination, project management, or workstream leadership experience.
- Healthcare industry experience required; health insurance or benefits administration experience strongly preferred.
- Experience working with medical policy, benefit configuration, or client implementation workflows.
- Strong project management and organizational skills with the ability to manage multiple priorities simultaneously.
- Experience coordinating cross-functional teams, including offshore resources.
- Strong analytical skills with the ability to interpret documentation, business rules, and claims-related data.
- Advanced Microsoft Excel skills, including formulas, functions, filtering, and tracking large data sets.
- Excellent written and verbal communication skills with experience presenting status updates to leadership.
- Strong stakeholder management skills and the ability to collaborate with technical and business teams.
Preferred Qualifications- Experience working with HealthRules is strongly preferred and will be a significant differentiator.
- Experience supporting health plan configuration or policy implementation initiatives.
- PMP certification is a plus.
- Experience with SharePoint, Microsoft PowerPoint, and Clarity PPM.
- Experience partnering with testing teams during system implementation projects.
- Experience working within large enterprise healthcare organizations.
What You'll Be DoingThis role supports a strategic enterprise initiative to transition TPA clients onto a modern benefits and medical policy platform. You'll work closely with implementation teams, business stakeholders, testing teams, and offshore configuration resources to ensure each client migration is successfully delivered. The ideal candidate is highly organized, analytical, comfortable managing multiple workstreams, and able to communicate effectively with both technical teams and executive leadership.