Director, Data Quality & Integrity (Provider Network Operations)

Become a part of our caring community   The Director, Data Quality/Integrity understands end-to-end master data processes and flows and uses that knowledge to design and implement master data management solutions. The Director, Data Quality/Integrity requires an in-depth understanding of how organization capabilities interrelate across the function or segment. This is a remote position. The Director, Provider Data Quality & Directory Governance is responsible for defining and executing the enterprise strategy for provider data quality, governance, directory accuracy, and innovation. This leader will establish the operating model, standards, controls, and continuous improvement practices that ensure provider data is accurate, complete, timely, compliant, and trusted across provider directories, network operations, credentialing, contracting, and digital experiences.   Reporting to the VP of Provider Network Operations, this role partners across Operations, Technology, Analytics, Compliance, Provider Services, and market leadership to improve provider data integrity, strengthen governance, reduce defects, and enhance provider and member experiences. The Director is expected to champion innovation, challenge traditional approaches, and actively collaborate both within the organization and across the healthcare industry to advance provider data management practices. Key Responsibilities Data Quality Strategy & Leadership • Develop and execute a multi-year data quality and integrity strategy aligned with organizational priorities. • Establish enterprise standards, policies, and operating models that support sustainable data quality practices. • Lead strategic initiatives focused on improving data accuracy, completeness, consistency, and timeliness. • Serve as a thought leader in data quality management, governance, and stewardship. Data Governance & Data Mastering • Lead data governance programs that define ownership, accountability, business rules, and quality standards for critical data assets. • Partner with business and technology leaders to establish data stewardship responsibilities and governance processes. • Oversee data mastering initiatives, including the identification, definition, and management of key enterprise data assets. • Drive alignment across stakeholders on data definitions, standards, and quality expectations. Data Integrity, Auditing & Controls • Design and implement data-driven auditing programs to proactively identify data anomalies, risks, and process weaknesses. • Establish monitoring frameworks and controls that improve visibility into data quality performance. • Lead reconciliation and validation processes to ensure alignment across multiple data sources. • Develop feedback mechanisms and continuous improvement processes that address root causes of data quality issues. Operational Excellence & Process Improvement • Conduct end-to-end assessments of business processes impacting data quality and integrity. • Lead provider directory data quality and integrity efforts to ensure compliance with CMS requirements, including accuracy, completeness, timely updates, and audit readiness. • Identify rework drivers, inefficiencies, and recurring quality issues and implement sustainable solutions. • Lead continuous improvement initiatives that improve operational effectiveness and reduce data-related defects. • Develop executive dashboards and reporting that provide actionable insights into quality performance. Technology, Vendor & Solution Management • Evaluate current and emerging data quality technologies and governance solutions. • Lead vendor assessments, RFP processes, and business case development for new capabilities. • Partner with Technology teams to implement tools that enhance auto