Senior Director, Provider Data & Credentialing Strategy

Alignment Healthcare USA, LLC in; Orange (CA); On-site; USD 150,000 - 225,000; Full time

Job summary

Alignment Health in California seeks a Senior Director, Provider Data Management (PDM) & Credentialing to lead data governance, credentialing operations, and network configuration. You will oversee end-to-end provider data lifecycle, ensuring accuracy, compliance, and alignment with contracts across systems.

You will partner with Network Management, Provider Contracting, Compliance, and Technology to drive data quality, regulatory readiness, and scalable transformation.

Qualifications

• 10+ years in healthcare in health plan environment.
• 7+ years leadership in Provider Operations, Data Management, Network Operations or Credentialing.
• Experience managing provider data across multiple source-of-truth systems.
• Experience with NCQA and CMS requirements.
• Knowledge of provider lifecycle, enrollment, contracts, and billing relations.

Responsibilities

• Lead enterprise provider data management, governance, and data quality across source systems and downstream platforms.
• Manage source-of-truth consistency across systems (credentialing, contracts, network tools, claims, directories).
• Oversee end-to-end credentialing and recredentialing operations for providers and facilities.
• Partner with Network Management, Provider Contracting, Compliance, Legal, and IT to align data with contract terms and regulatory standards.
• Drive operational transformation, automation, and data-driven improvements.

Skills

Provider data management

Network operations

Credentialing operations

Data governance

Process improvement

Regulatory compliance

Leadership

Education

Bachelor's degree in Healthcare Administration / related field

Master's degree preferred

Job description

Alignment Health in California seeks a Senior Director, Provider Data Management (PDM) & Credentialing to lead data governance, credentialing operations, and network configuration. You will oversee end-to-end provider data lifecycle, ensuring accuracy, compliance, and alignment with contracts across systems.

You will partner with Network Management, Provider Contracting, Compliance, and Technology to drive data quality, regulatory readiness, and scalable transformation.