TPA Data Manager -P&C Insurance

TPA Data Manager

Location: Blue Bells, PA (Hybrid, need locals only)

Type: Contract to Hire

Position Summary

We are seeking a highly experienced TPA Data Manager , Subject Matter Expert (SME) and Business Data Analyst to support the existing landscape and the modernization of our Third-Party Administrator (TPA) Data Services platform as part of our enterprise transformation initiatives, including Project NOVA and Guidewire modernization.

This role will be responsible to lead the TPA Data services workstream and for translating business requirements into scalable data solutions, improving TPA data quality and operational processes, and supporting the migration from legacy data ingestion and reporting methods to modern cloud-based data platforms leveraging Microsoft Fabric, Azure, and advanced analytics capabilities.

The ideal candidate possesses deep TPA operations knowledge, strong business analysis skills, and the ability to work directly with data, stakeholders, and technology teams to drive modernization efforts and business outcome.

Key Responsibilities

Team Leadership & People Management

• Lead and mentor a team of Business Data Analysts, Data Engineers, and TPA Data Analysts.
• Establish team goals, priorities, performance expectations, and professional development plans.
• Conduct hiring, onboarding, coaching, performance reviews, and career progression discussions.
• Foster a culture of accountability, collaboration, continuous improvement, and customer service.
• Develop TPA domain expertise across the team through training and knowledge-sharing initiatives.
• Build succession plans and cross-functional skill development programs.

TPA Domain Leadership

• Act as the primary SME for TPA data, claims, policy, and financial reporting processes.
• Understand end-to-end claim lifecycle and TPA operational workflows.
• Provide guidance on industry standards, regulatory reporting, bordereaux processing, and carrier reporting requirements.
• Partner with Claims, Underwriting, Finance, Actuarial, and Risk Management teams to identify improvement opportunities.
• Define and document business rules, data definitions, and operational metrics.

Business Analysis

• Elicit, document, and manage business requirements and user stories.
• Facilitate workshops and working sessions with business stakeholders and TPAs.
• Translate business requirements into functional and technical specifications.
• Create process maps, workflows, future-state operating models, and requirements documentation.
• Support Agile delivery teams through backlog refinement, sprint planning, and user acceptance testing.

Data Analysis & Modernization

• Analyze TPA claim, financial, and operational data from multiple sources.
• Perform data mapping and transformation analysis across legacy and target platforms.
• Define source-to-target mappings and business transformation rules.
• Support data conversion, reconciliation, and validation activities.
• Collaborate with Data Engineering teams on ingestion frameworks, data quality controls, and modernization initiatives.
• Assist in developing enterprise KPIs, dashboards, and operational reporting.

Data Governance & Quality

• Define and monitor data quality rules and controls.
• Identify data anomalies and root causes.
• Establish data stewardship practices across TPA programs.
• Support data cataloging, metadata management, and business glossary efforts.
• Partner with governance teams to ensure compliance with regulatory and audit requirements.

Stakeholder Management

• Serve as a liaison between business stakeholders, TPAs, vendors, and technology teams.
• Provide executive-ready summaries and status updates.
• Facilitate issue resolution and drive decisions across multiple teams.
• Coordinate with external TPAs, software vendors, and implementation partners.

Required Qualifications

Experience

• 10+ years of experience in Property & Casualty insurance.
• 5+ years working with TPA operations, claims administration, or managed claims programs.
• 5+ years of Business Analyst or Data Analyst experience.
• Experience supporting enterprise data modernization or transformation initiatives.
• Experience working with Agile delivery methodologies.

Domain Knowledge

Strong understanding of:

• TPA claim administration
• Workers’ Compensation
• General Liability
• Auto Liability
• Property Claims
• Claim financial transactions
• Loss runs and bordereaux
• Reserve and payment reporting
• Insurance operational reporting
• Carrier-TPA data exchange processes

Technical Skills

• SQL and data analysis
• Advanced Excel
• Microsoft Fabric, Azure, or cloud analytics platforms
• Power BI reporting and dashboarding
• Data mapping and transformation analysis
• Data quality analysis
• ETL concepts
• API and file-based integrations

Business Analysis Skills

• Requirements gathering
• Process modeling
• Gap analysis
• User story creation
• UAT planning and execution
• Stakeholder management
• Documentation and presentation skills

Preferred Qualifications

• Experience with Guidewire ClaimCenter.
• Experience working with RMIS platforms.
• Experience with Bordereaux processing and claims data conversions.
• Understanding of data warehousing and dimensional modeling.
• Experience with Microsoft Fabric Lakehouse and Warehouse architectures.
• Experience working with insurance mergers, acquisitions, or system migrations.
• CBAP, PMI-PBA, or equivalent certification.

Core Competencies

• Analytical problem-solving and structured root-cause analysis.
• Clear written and verbal communication with technical and nontechnical audiences.
• Business acumen and the ability to connect analytics work to measurable outcomes.
• Accountability, ownership, and disciplined follow-through.
• Ability to manage priorities, communicate risks early, and operate effectively in a changing environment.
• Collaborative, service-oriented mindset with a commitment to data quality and user experience.
• Continuous-learning mindset and interest in modern analytics, automation, and AI-enabled delivery methods.

Measures of Success

• Establish documented business and data standards across all TPA programs.
• Reduce manual effort associated with TPA data analysis and reconciliation.
• Improve TPA data quality, timeliness, and completeness.
• Support successful onboarding of new TPA data sources into the enterprise platform.
• Deliver business requirements for Project NOVA and TPA modernization initiatives.
• Become the trusted SME for TPA data across Claims, Finance, Actuarial, and Technology teams.
• Drive measurable improvements in operational reporting and decision-making.

Work Environment

• Hybrid work environment with collaboration across business, technology, and partner teams.
• Participation in planning, design, testing, deployment, production support, and continuous-improvement activities.
• Occasional after-hours support may be required for planned releases or critical production issues.