Sr. Data Quality Analyst, PDM

Alignment Healthcare USA; Stati Uniti; In loco; USD 110.000 - 170.000; Tempo pieno

Descrizione del lavoro

Alignment Health is seeking a Sr. Data Quality Analyst, PDM to lead provider data quality initiatives and governance across the organization, partnering closely with operations, credentialing, enrollment, and claims teams.

You will drive data quality programs, root-cause analysis, and corrective action plans to ensure accurate, compliant provider data and directory representations. This role combines business process expertise with data analysis to establish sustainable data quality processes,

Mansioni

• Lead provider data quality initiatives across provider lifecycle management processes, including contracting, credentialing, enrollment, maintenance, and termination activities.
• Develop and maintain data quality frameworks, standards, controls, and key performance indicators (KPIs).
• Identify data quality issues through analytics, audits, monitoring, and stakeholder feedback.
• Perform root cause analysis of provider data defects and recommend corrective and preventive actions.
• Establish ongoing quality assurance and validation processes to improve provider record accuracy.
• Drive remediation efforts for identifying provider data discrepancies and systemic issues.
• Support enterprise provider directory accuracy programs designed to meet regulatory and accreditation requirements.
• Monitor directory performance metrics and identify trends impacting member and provider experience.
• Partner with compliance teams to support CMS, state, NCQA, and accreditation-related directory requirements.
• Design and implement controls that improve provider directory accuracy and reduce regulatory risk.
• Support readiness activities, audits, corrective action plans, and regulatory reporting.
• Serve as a business lead for provider data governance initiatives.
• Define and maintain provider data definitions, business rules, standards, and stewardship responsibilities.
• Partner with business and technology teams to establish governance processes for provider master data.
• Facilitate governance forums and stakeholder discussions focused on data ownership, accountability, and quality improvement.
• Support the development of policies, procedures, and operating models related to provider data management.
• Analyze provider data across multiple source systems to identify quality issues, trends, gaps, and opportunities.
• Develop dashboards and reporting solutions that provide visibility into data quality performance and operational effectiveness.
• Measure the impact of data quality initiatives through established metrics and business outcomes.
• Present findings, recommendations, and progress updates to leadership and cross-functional stakeholders.
• Assess end-to-end provider operational processes and identify opportunities to improve data accuracy and operational efficiency.
• Lead continuous improvement initiatives using structured problem-solving methodologies.
• Document current-state and future-state workflows related to provider data management and directory operations.
• Partner with operational teams to implement sustainable process improvements.
• Support automation and technology solutions that improve data quality, governance, and operational effectiveness.
• Collaborate with Network Management, Credentialing, Provider Enrollment, Claims, Digital, Product, Compliance, and Technology teams.
• Serve as a trusted advisor on provider data-related initiatives and enterprise transformation efforts.
• Support strategic projects involving provider data modernization, provider lifecycle management, and directory optimization.
• Facilitate stakeholder alignment

Descrizione del lavoro

Alignment Health is breaking the mold in conventional health care, committed to serving seniors and those who need it most: the chronically ill and frail. It takes an entire team of passionate and caring people, united in our mission to put the senior first. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment Health community. Working at Alignment Health provides an opportunity to do work that really matters, not only changing lives but saving them. Together.

The Sr. Data Quality Analyst, PDM is responsible for leading strategic and operational initiatives that improve the quality, accuracy, integrity, and governance of provider data across the organization. This role partners closely with Provider Operations, Credentialing, Network Management, Provider Enrollment, Claims, Digital, Compliance, Product, and Technology teams to ensure provider data is accurate, compliant, and consistently represented across all internal and external systems.

This role serves as a subject matter expert in provider data management and provider directory operations, driving data quality programs, root cause analysis, governance practices, monitoring frameworks, and corrective action plans that improve provider directory accuracy and member/provider experience while reducing operational and regulatory risk.

This position combines business process expertise, data analysis, governance leadership, and operational consulting to establish sustainable data quality processes and support provider data transformation initiatives.

Job Duties/Responsibilities:

Provider Data Quality & Integrity

• Lead provider data quality initiatives across provider lifecycle management processes, including contracting, credentialing, enrollment, maintenance, and termination activities.
• Develop and maintain data quality frameworks, standards, controls, and key performance indicators (KPIs).
• Identify data quality issues through analytics, audits, monitoring, and stakeholder feedback.
• Perform root cause analysis of provider data defects and recommend corrective and preventive actions.
• Establish ongoing quality assurance and validation processes to improve provider record accuracy.
• Drive remediation efforts for identifying provider data discrepancies and systemic issues.

Provider Directory Accuracy & Regulatory Compliance

• Support enterprise provider directory accuracy programs designed to meet regulatory and accreditation requirements.
• Monitor directory performance metrics and identify trends impacting member and provider experience.
• Partner with compliance teams to support CMS, state, NCQA, and accreditation-related directory requirements.
• Design and implement controls that improve provider directory accuracy and reduce regulatory risk.
• Support readiness activities, audits, corrective action plans, and regulatory reporting.

Data Governance

• Serve as a business lead for provider data governance initiatives.
• Define and maintain provider data definitions, business rules, standards, and stewardship responsibilities.
• Partner with business and technology teams to establish governance processes for provider master data.
• Facilitate governance forums and stakeholder discussions focused on data ownership, accountability, and quality improvement.
• Support the development of policies, procedures, and operating models related to provider data management.

Data Analysis & Reporting

• Analyze provider data across multiple source systems to identify quality issues, trends, gaps, and opportunities.
• Develop dashboards and reporting solutions that provide visibility into data quality performance and operational effectiveness.
• Measure the impact of data quality initiatives through established metrics and business outcomes.
• Present findings, recommendations, and progress updates to leadership and cross-functional stakeholders.

Process Improvement & Operational Excellence

• Assess end-to-end provider operational processes and identify opportunities to improve data accuracy and operational efficiency.
• Lead continuous improvement initiatives using structured problem-solving methodologies.
• Document current-state and future-state workflows related to provider data management and directory operations.
• Partner with operational teams to implement sustainable process improvements.
• Support automation and technology solutions that improve data quality, governance, and operational effectiveness.

Cross-Functional Collaboration

• Collaborate with Network Management, Credentialing, Provider Enrollment, Claims, Digital, Product, Compliance, and Technology teams.
• Serve as a trusted advisor on provider data-related initiatives and enterprise transformation efforts.
• Support strategic projects involving provider data modernization, provider lifecycle management, and directory optimization.
• Facilitate stakeholder alignment