[Hiring] Senior Director, Provider Data Management & Credentialing @Alignment Health

Role Description

The Senior Director, Provider Data Management (PDM) & Credentialing is responsible for the strategic leadership, governance, and operational execution of provider data management, credentialing, network configuration support, and provider record integrity across the organization. This role ensures provider data is accurate, complete, compliant, and synchronized across all systems of record while aligning provider information, network relationships, contract identifiers, and reimbursement structures with contractual intent.

This leader partners closely with Network Management, Provider Contracting, Provider Operations, Technology, Compliance, Product, Claims, Configuration, and Vendor Management teams to ensure the provider data ecosystem supports organizational growth, regulatory compliance, provider satisfaction, and member experience.

Qualifications

• 10+ years of progressive healthcare experience within a health plan environment.
• 7+ years of leadership experience within Provider Operations, Provider Data Management, Network Operations, Credentialing Operations, or related functions.
• Demonstrated experience managing provider data across multiple systems and source-of-truth environments.
• Experience supporting contract implementation, provider network setup, contract IDs, reimbursement structures, and rate schedule management.
• Experience with NCQA accreditation requirements and CMS regulations (preferred).
• Experience implementing Provider Lifecycle Management (PLM) platforms (preferred).
• Knowledge of provider master data management concepts and data governance frameworks (preferred).
• Experience with provider data technologies, workflow automation solutions, and digital transformation initiatives (preferred).
• Lean Six Sigma, PMP, or related operational excellence certifications (preferred).

Requirements

• Bachelor's degree in Healthcare Administration, Business Administration, Health Informatics, Information Systems, or related field (required).
• Master's degree in Healthcare Administration, Business Administration, Health Informatics, Information Systems, or related field (preferred).

Benefits

• Pay Range: $149,882.00 - $224,823.00
• Pay range may be based on a number of factors including market location, education, responsibilities, experience, etc.

Essential Physical Functions

• While performing the duties of this job, the employee is regularly required to talk or hear.
• The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
• The employee frequently lifts and/or moves up to 10 pounds.
• Specific vision abilities required by this job include close vision and the ability to adjust focus.