Director, Data Quality & Integrity (Provider Network Operations)

Accountabilities: Data Quality Strategy & Leadership: Develop and execute a multi-year enterprise strategy for provider data quality and integrity, establishing standards, policies, operating models, and continuous improvement initiatives aligned with organizational priorities. Data Governance & Master Data Management: Lead governance programs that define data ownership, accountability, stewardship responsibilities, business rules, and quality standards. Oversee master data management initiatives and ensure consistency across critical enterprise data assets. Data Integrity, Auditing & Controls: Design data-driven auditing programs, monitoring frameworks, reconciliation processes, and validation controls to identify anomalies, mitigate risks, and ensure data consistency across multiple sources. Provider Directory Accuracy & Compliance: Oversee provider directory data quality initiatives to ensure accuracy, completeness, timely updates, audit readiness, and compliance with applicable Centers for Medicare & Medicaid Services (CMS) requirements. Operational Excellence & Process Improvement: Assess end-to-end business processes, identify recurring defects and inefficiencies, address root causes, and implement sustainable improvements that reduce rework and enhance operational performance. Analytics & Performance Reporting: Develop executive dashboards, performance metrics, and actionable reporting that provide visibility into data quality trends, operational risks, and progress toward strategic objectives. Technology & Vendor Management: Evaluate data quality technologies, governance platforms, and emerging solutions. Lead vendor assessments, requests for proposals (RFPs), and business case development while partnering with technology teams to improve automation and monitoring capabilities. Stakeholder Collaboration & Change Leadership: Build strong partnerships across operations, technology, analytics, compliance, provider services, market leadership, and external vendors. Present strategic recommendations to executives and lead change initiatives that establish enterprise-wide accountability for data quality. Requirements Education: Bachelor's degree in Business, Healthcare Administration, Information Systems, Data Analytics, or a related field. A master's degree in a relevant discipline is preferred. Leadership Experience: At least 8 years of leadership experience in provider data management, provider directory operations, data governance, data quality, network operations, or related healthcare functions. Healthcare Data Expertise: In-depth understanding of provider data domains, including directory information, demographics, provider affiliations, specialties, credentialing, contracting, and relevant regulatory requirements. Governance & Quality Management: Demonstrated experience designing and implementing enterprise data governance frameworks, data stewardship models, quality controls, auditing programs, and master data management practices. Transformation & Process Improvement: Proven ability to lead large-scale, cross-functional transformation initiatives involving business and technology teams, with measurable improvements in data integrity and operational effectiveness. Regulatory & Compliance Knowledge: Experience with provider directory accuracy programs, regulatory audits, accreditation requirements, and provider network operations is preferred. Technology & Analytical Skills: Familiarity with data governance platforms, master data management solutions, data quality tools, automated monitoring, and performance reporting is highly desirable. Strategic Communication & Influence: Strong executive presence, stakeholder management, and communication skills, with the ability to translate complex data challenges into clear business priorities and actionable recommendations. Professional Certifications: Lean, Six Sigma, Data Governance, or Data Management certifications are preferred. Remote Work Requirements: Ability to work remotely from a dedicated, secure workspace that protects confidential member information and complies with HIPAA privacy requirements. A reliable internet connection with at least 25 Mbps download and 10 Mbps upload speeds is required; wired cable or DSL is suggested. Additional Conditions: This position is not eligible for work visa sponsorship. Occasional travel to company offices for training or meetings may be required. Benefits Competitive Salary: Annual base salary ranging from $156,600 to $215,400 , depending on geographic location, qualifications, experience, education, certifications, and relevant skills. Performance-Based Incentives: Eligibility for a bonus incentive plan based on individual and/or organizational performance. Comprehensive Healthcare Coverage: Medical, dental, and vision insurance options designed to support employees and their families. Retirement Planning: Access to a 401(k) retirement savings plan. Paid Time Off: Paid time off, company holidays, and personal holidays to support work-life balance. Family Support: Paid parental and caregiver leave. Financial Protection: Short-term disability, long-term disability, and life insurance benefits. Remote Work Flexibility: Nationwide remote work arrangement, with occasional travel for training or business meetings as needed. Professional Impact & Growth: The opportunity to lead enterprise-wide data transformation, influence strategic decisions, collaborate with senior leadership, and advance innovative healthcare data management practices. Work Schedule: Full-time position with a standard schedule of 40 hours per week. Application Deadline: October 29, 2026.