Director, Data Quality & Integrity (Provider Network Operations)

This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Director, Data Quality & Integrity (Provider Network Operations) based in the United States. As Director, Data Quality & Integrity, you will shape the enterprise strategy for provider data quality, governance, and directory accuracy across a nationwide healthcare network. You will lead initiatives that improve data reliability, regulatory compliance, and operational efficiency while strengthening provider and member experiences. Working closely with executive leaders and cross-functional teams, you will establish governance frameworks, quality standards, and sustainable data management practices. You will drive innovation through automation, advanced monitoring, and data-driven decision-making. This role offers the opportunity to influence enterprise-wide transformation, modernize provider data operations, and establish industry-leading practices in data integrity. This is a full-time, remote leadership opportunity for an experienced professional passionate about turning complex data challenges into measurable business outcomes.

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: E…