Director, Data Quality & Integrity (Provider Network Operations)

Humana; United States; Remote; USD 180,000 - 240,000; Full time

Job summary

Humana is seeking a Director of Provider Data Quality & Directory Governance to define and execute the enterprise strategy for provider data quality, governance, and directory accuracy. This leader will establish operating models, standards, controls, and continuous improvement practices across provider directories, network operations, credentialing, contracting, and digital experiences.

Reporting to the VP of Provider Network Operations, you will collaborate across Operations, Technology,

Qualifications

• Bachelor's degree in a related field is required and leadership experience in provider data management, governance, or related healthcare functions is essential.
• Experience designing enterprise data governance frameworks, stewardship models, quality controls, and auditing processes is required.
• Deep understanding of provider data domains, including directory data, demographics, affiliations, specialties, credentialing, contracting, and regulatory requirements.

Responsibilities

• Define and execute a multi-year data quality and integrity strategy aligned with organizational priorities.
• Lead data governance programs with ownership, business rules, and quality standards for critical data assets.
• Design auditing programs to identify data anomalies, risks, and process weaknesses and establish monitoring frameworks.
• Lead provider directory data quality and integrity efforts to ensure CMS compliance, accuracy, timeliness, and audit readiness.
• Develop executive dashboards and reporting that provide actionable insights into quality performance.

Skills

Leadership

Data governance

Data quality

Auditing

Stakeholder management

Strategic thinking

Communication

Education

Bachelor's degree in Business, Healthcare Administration, Information Systems, Data Analytics, or related field

Job description

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 automation, monitoring, and data governance.
• Assess market-leading practices and identify opportunities to improve quality management capabilities.

Stakeholder Partnership & Influence

• Build strong relationships with operational leaders, technology teams, analytics partners, and external vendors.
• Facilitate cross-functional alignment on data quality priorities and governance decisions.
• Present findings, recommendations, and strategic roadmaps to executive leadership.
• Lead organizational change efforts that promote enterprise ownership of data quality.

Use your skills to make an impact

This role is not eligible for work visa sponsorship.

Required Qualifications

• Bachelor's degree in Business, Healthcare Administration, Information Systems, Data Analytics, or a related field.
• 8+ years of leadership experience in provider data management, provider directory operations, data governance, data quality, network operations, or related healthcare functions.
• Deep understanding of provider data domains, including directory data, demographics, affiliations, specialties, credentialing, contracting, and regulatory requirements.
• Experience designing and implementing enterprise data governance frameworks, stewardship models, quality controls, and auditing pro