Director, Provider Data Integrity & Governance (Remote)

SHPCA SCAN Health Plan; California (MO); Hybrid; USD 147,900 - 205,000; Full time

Benefits offered by this job

Remote work

Annual bonus program

Wellness program

Generous PTO

11 paid holidays + floating holiday

Job summary

SCAN Health Plan is seeking a Director of Provider Data Operations to ensure accurate, timely, and governed provider information across the enterprise. The role drives a single source of truth for provider data, enabling downstream processes with reliable intelligence and governance.

You will lead cross-functional teams, advance data quality controls, and implement AI-enabled capabilities to improve accuracy and efficiency while ensuring CMS and state compliance.

Qualifications

• Bachelor's Degree or 5+ years equivalent work experience.
• 2+ years of leadership experience.
• 2+ years leading Provider Data Management teams at a managed care provider organization or insurance company.
• 5+ years of overall Healthcare experience.

Responsibilities

• Leads end-to-end provider data operations across records, verification, roster management, reconciliation, and governance.
• Establishes quality standards, validation controls, and root-cause resolution to prevent recurring data defects.
• Partners with Operations, Technology, Compliance, Product, and network groups to improve provider data across enterprise processes.
• Ensures CMS and state regulatory readiness and data accuracy across internal and external directories.

Skills

Leadership

Provider Data Management

Healthcare experience

Education

Bachelor's Degree or 5+ years equivalent work experience

Job description

SCAN Health Plan is seeking a Director of Provider Data Operations to ensure accurate, timely, and governed provider information across the enterprise. The role drives a single source of truth for provider data, enabling downstream processes with reliable intelligence and governance.

You will lead cross-functional teams, advance data quality controls, and implement AI-enabled capabilities to improve accuracy and efficiency while ensuring CMS and state compliance.