Job Description
A bit about this role:
Accurate, complete, and timely provider data is foundational to how we serve our members and support our providers. It powers the provider directory, helps members find and navigate care, reduces administrative burden for providers, and supports critical processes including claims, utilization management, credentialing, network operations, care navigation, and reporting. Because provider data is complex, interconnected, and constantly changing, strong processes to monitor, verify, and improve its accuracy are essential to our member and provider experiences, operational performance, and compliance with federal and state requirements.
The Manager will help drive operational excellence across the provider data lifecycle—from onboarding and initial configuration through ongoing maintenance and verification—with particular focus on ensuring that records affecting member care are accurate, complete, and up to date. By connecting operational insights, stakeholder feedback, and data trends, this person will identify opportunities to strengthen processes, improve data quality, and prevent issues before they impact members, providers, or downstream business operations. We’re looking for a self-starter who can bring structure to ambiguous problems, manage multiple initiatives, and move work from insight to implementation.
Your responsibilities and impact will include:
- Support and advance initiatives that improve the accuracy, completeness, timeliness, and scalability of provider and facility data operations from onboarding through ongoing maintenance and verification
- Help oversee the operating performance of offshore teams and automated solutions supporting provider data and verification initiatives, including monitoring quality, productivity, capacity, and issue trends
- Develop and maintain reporting, dashboards, and monitoring that provide visibility into operational performance, verification results, data quality trends, emerging risks, and opportunities for intervention
- Partner with product and engineering to define requirements, test enhancements, and improve the usability, accuracy, and scalability of verification tools and workflows
- Help design, build, and monitor AI agents and other automation solutions that improve the efficiency, scalability, and accuracy of provider data operations and initiatives
- Analyze root causes of recurring data issues and recommend process, tooling, or upstream improvements that prevent issues from recurring
- Partner with claims and other internal data teams to develop reporting and analyses that quantify the operational and business impact of provider data issues
- Serve as a flexible operational leader who can build structure in ambiguous environments, take on new problem areas, and shift priorities as business and member needs evolve
Required skills and experience:
- Bachelor’s degree and 3–5+ years of relevant experience in healthcare operations, provider data, provider directory, credentialing, claims, network operations, data quality, or a related field
- Experience managing operational workflows involving provider data, record validation, data quality, research, verification, or issue remediation
- Demonstrated ability to build, document, and scale repeatable operational processes with measurable quality and productivity outcomes
- Strong analytical skills, including the ability to investigate data issues, identify patterns and anomalies, and translate findings into clear operational actions
- Experience building or maintaining dashboards, reporting, or monitoring tools to identify risks and track performance
- Experience partnering with product and engineering teams to define requirements, test enhancements, and improve operational tooling
- Strong project management, communication, and organizational skills, with the ability to prioritize competing needs and work effectively with offshore teams and cross-functional partners
- Self-directed and comfortable operating in a fast-paced, metrics-driven environment with ambiguity and evolving priorities
Desired skills and experience:
- Experience managing or scaling offshore, vendor, or shared-services teams
- Experience applying AI, agentic workflows, machine learning, or automation to reduce manual operational work
- SQL or equivalent ability to query, join, and validate provider, claims, or operational data directly
- Familiarity with provider directory requirements, CMS Medicare Advantage directory accuracy expectations, or other healthcare data and network regulations
Salary Range: $73,000-$115,000/year
The pay range listed for this position is the range the organization reasonably and in good faith expects to pay for this position at the time of the posting. Once the interview process begins, your talent partner will provide additional information on the compensation for the role, along with additional information on our total rewards package. The actual base salary offered will depend on a variety of factors, including the qualifications of the individual applicant for the position, years of relevant experience, specific and unique skills, level of education attained, certifications or other professional licenses held, and the location in which the applicant lives and/or from which they will be performing the job.
Our Total Rewards package includes:
Employer sponsored health, dental and vision plan with low or no premium
Generous paid time off
$100 monthly mobile or internet stipend
Stock options for all employees
Bonus eligibility for all roles excluding Director and above; Commission eligibility for Sales roles
Parental leave program
401K program
And more....
*Our total rewards package is for full time employees only. Intern and Contract positions are not eligible.
