Manager / Lead Specialist - Healthcare Data Operations and Implementation

Manager / Lead Specialist - US Healthcare - Data Operations & Implementation

Company:

Mercer

Description:

Mercer is seeking candidates for the following position based in the GGN / Noida office

This is a hybrid role that has a requirement of working at least three days a week in the office.

Manager / Lead Specialist - Metrics, Analytics & Reporting - Grade D

What can you expect?

The Data Operations & Implementation Analyst is the operational core of the team, responsible for getting client data into the analytics platform accurately, completely, and on time. This role manages the end-to-end data lifecycle for employer health benefits accounts — from the moment an engagement is signed through ongoing monthly data feed operations.

This person sits between three worlds: the client (who owns the data), the carrier/PBM (who holds the data), and the analytics platform (which needs the data). Their job is to make sure data moves correctly through all three — and when it does not, to find out why and fix it.

We will count on you for:

Implementation & Onboarding

• Lead end-to-end data implementation for new client accounts — from kick-off through go-live sign-off
• Identify and document all required data feeds for each new client account: medical claims, pharmacy (Rx), eligibility, dental, vision
• Conduct kick-off calls with clients to establish data requirements, timelines, authorization processes, and escalation paths
• Obtain and review data dictionaries from each carrier — document field mappings for ETL configuration
• Track data request status across all sources; conduct weekly follow-up with carriers and PBMs to maintain timeline

Data Receipt & Validation

• Receive incoming data files via secure FTP; verify file integrity, record counts, and date range upon receipt
• Log all received files in the data tracking register with source, date, record count, and file format
• Perform eligibility file validation — member count checks, coverage date checks, Member ID format alignment, plan code verification, ZIP code validation
• Conduct initial claims file checks — verify expected carriers are represented, date ranges are complete, and financial totals are within expected ranges

Quality Review Testing (QRT)

• Execute QRT checklist following initial data load — record count reconciliation, member count reconciliation, date range verification, financial reconciliation, code validation
• Document all QRT findings in the issue log with issue type, specific example, resolution action, and owner
• Coordinate with carriers, PBMs, and client HR teams to resolve data quality issues identified during QRT
• Re-test affected data dimensions following issue resolution to confirm closure

What you need to have: 

• Graduate in any discipline. No specific stream requirement.
• 5–10 years in data operations, healthcare data management, or a related function. Direct experience managing healthcare claims data feeds is strongly preferred.
• Prior experience in managed care, TPA, or health analytics implementation environment. Carrier-specific data knowledge (Aetna, BCBS, Cigna, UHC, Express Scripts) is a significant advantage.
• Healthcare, data, or analytics certifications are a plus (Not mandatory)

Technical Skills

• Proficiency in Microsoft Excel — data validation, reconciliation, record matching across large files
• Ability to work with structured data files — CSV, flat files, EDI formats
• Basic SQL or database query skills preferred — ability to count, filter, and compare records
• Familiarity with SFTP tools (WinSCP, FileZilla) and secure file handling

Domain Knowledge

• Strong command of US health benefits landscape — self-insured vs. fully-insured, stop-loss, TPA/PBM ecosystem
• Basic understanding of claims data structure — medical and pharmacy claim fields, adjudication logic, allowed vs. billed vs. paid amounts
• Awareness of key metrics key metrics — PMPM, PEPM, trend rate, utilization vs. unit cost decomposition, episode cost benchmarking
• Understanding of healthcare data identifiers — Member ID, NPI, NDC, ICD-10, CPT, HCPCS

Behavioral Competencies

• Analytical ownership — takes full responsibility for accuracy and completeness of outputs
• Proactive communication — does not wait to be asked, flags issues and opportunities early
• Consultative thinking — connects analytical findings to business implications and action
• Coaching mindset — invests in the development of junior team members

What makes you stand out?

• Adaptable communicator, facilitator, influencer and problem solver
• High attention to detail
• Good relationship skills, Proven ability to work on own initiative as well as in a team 
• Ability to multi-task and prioritize time effectively

Why join our team?

• We help you be your best through professional development opportunities, interesting work and supportive leaders.
• We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have impact for colleagues, clients and communities.
• Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being.

Mercer is a business of Marsh (NYSE: MRSH), a global leader in risk, reinsurance and capital, people and investments, and management consulting, advising clients in 130 countries. With annual revenue of over $27 billion and more than 95,000 colleagues, Marsh helps build the confidence to thrive through the power of perspective. For more information about Mercer, visit mercer.com, or follow us on LinkedIn and X.Marsh is committed to embracing a diverse, inclusive and flexible work environment. We aim to attract and retain the best people and embrace diversity of age, background, caste, disability, ethnic origin, family duties, gender orientation or expression, gender reassignment, marital status, nationality, parental status, personal or social status, political affiliation, race, religion and beliefs, sex/gender, sexual orientation or expression, skin color, or any other characteristic protected by applicable law.Marsh is committed to hybrid work, which includes the flexibility of working remotely and the collaboration, connections and professional development benefits of working together in the office. All Marsh colleagues are expected to be in their local office or working onsite with clients at least three days per week. Office-based teams will identify at least one “anchor day” per week on which their full team will be together in person.

Experience Level

Senior Level