Senior Director of Provider Data & Credentialing

E2E Alignment Healthcare USA, LLC; California; Hybrid; USD 150,000 - 225,000; Full time

Job summary

Alignment Health in California is seeking a Senior Director, Provider Data Management (PDM) & Credentialing to lead the enterprise provider data lifecycle, QA, and governance across source systems and downstream platforms.

You will oversee credentialing, network participation, and data quality, partnering with Legal, Compliance, and IT to ensure regulatory readiness and accurate provider records. This role drives transformation and sets KPIs to support growth and reimbursement integrity.

Qualifications

• 10+ years in healthcare, with leadership in provider operations or credentialing.
• Experience managing provider data across multiple systems.
• Knowledge of NCQA and CMS requirements.
• Bachelor's degree required; Master's preferred.

Responsibilities

• Lead provider data management strategy and governance.
• Oversee end-to-end credentialing operations for providers and facilities.
• Ensure data accuracy across source systems and downstream platforms.
• Partner with Legal, Compliance, IT, Network Management, and Provider Contracting.

Skills

Provider data management

Data governance

Leadership

Regulatory compliance

Strategic planning

Education

Bachelor's degree

Master's degree preferred

Job description

Alignment Health in California is seeking a Senior Director, Provider Data Management (PDM) & Credentialing to lead the enterprise provider data lifecycle, QA, and governance across source systems and downstream platforms.

You will oversee credentialing, network participation, and data quality, partnering with Legal, Compliance, and IT to ensure regulatory readiness and accurate provider records. This role drives transformation and sets KPIs to support growth and reimbursement integrity.