Director of Provider Data Management

Job Summary

A company is looking for a Director of Provider Data Management and Credentialing.

Key Responsibilities

• Lead and mentor a team in provider data management and credentialing
• Develop strategies to optimize provider data accuracy and operational processes
• Ensure compliance with industry regulations and manage credentialing activities

Required Qualifications

• At least 15 years of experience in health plan operations, focusing on provider data management and credentialing
• Proven experience managing teams and large-scale operations
• Strong background in AI-driven process optimization and automation in healthcare
• Knowledge of industry regulations such as NCQA and URAC
• Experience with provider data management systems and credentialing platforms