Provider Data Quality Manager — Directory Audit Lead

Point32Health; Canton (MA); On-site; USD 104,612 - 156,918; Full time

Benefits offered by this job

Medical, dental, and vision coverage

Retirement plans

Paid time off

Employer-paid life and disability

Tuition program

Well-being benefits

Career development opportunities

Job summary

Point32Health is seeking a Manager, Provider Data Quality to lead and advance the provider directory quality audit program, including the AI Agent for Directory Audit. You will drive data accuracy, lead a team, and ensure compliance with Medicaid, Medicare, and Commercial directory regulations.

The role requires 5–7 years in managed healthcare, strong leadership, and expertise in Excel and Microsoft tools to monitor audits and performance metrics.

Qualifications

• Associate’s or bachelor’s degree preferred; equivalent work experience acceptable.
• 5–7 years’ experience in a managed healthcare organization.
• Proficiency with Excel and other Microsoft programs for tracking, updating, and analyzing data.
• Strong verbal and written communication skills.
• Ability to work in a high-volume, fast-paced, goal-oriented environment with quality focus.
• Proven ability to function independently.

Responsibilities

• Facilitate the development, implementation, and continuous improvement of an end‑to‑end process supporting provider data audits.
• Design and implement a comprehensive provider directory and data audit program.
• Establish policies, procedures, and standards for provider data management and audits, including roster reconciliation.
• Ensure compliance with all relevant provider directory regulations and standards.
• Oversee the enterprise provider directory & attestation platform vendor performance.
• Establish key performance indicators and metrics to measure the effectiveness of the provider directory and data audit program.
• Perform other duties as assigned by management.

Skills

Program development

Team leadership

Communication

Independent work

Education

Associate/Bachelor degree

Tools

Excel

Microsoft Office

Job description

Point32Health is seeking a Manager, Provider Data Quality to lead and advance the provider directory quality audit program, including the AI Agent for Directory Audit. You will drive data accuracy, lead a team, and ensure compliance with Medicaid, Medicare, and Commercial directory regulations.

The role requires 5–7 years in managed healthcare, strong leadership, and expertise in Excel and Microsoft tools to monitor audits and performance metrics.