Manager, Provider Operations - Provider Data

This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Manager, Provider Operations – Provider Data based in the United States.

As a Manager, Provider Operations – Provider Data, you will play a key role in improving the accuracy, completeness, and reliability of healthcare provider information. You will oversee operational initiatives across the provider data lifecycle, from onboarding and initial configuration to ongoing maintenance and verification. By combining data analysis, performance monitoring, and process improvement, you will help ensure that members can find appropriate care and providers are accurately represented in healthcare directories. You will collaborate with product, engineering, claims, and other cross-functional teams to strengthen workflows and develop scalable solutions. The role also offers opportunities to leverage AI-powered tools and automation to improve operational efficiency and data quality. This is an excellent opportunity for a proactive, analytical professional who thrives in a fast-paced environment and wants to make a meaningful impact on healthcare delivery and member experience.

• Provider Data Operations: Drive initiatives that improve the accuracy, completeness, timeliness, and scalability of provider and facility data operations throughout the entire data lifecycle, including onboarding, initial configuration, ongoing maintenance, and verification.
• Operational Performance Management: Monitor the performance of offshore teams and automated solutions supporting provider data operations. Evaluate quality, productivity, capacity, and recurring issue trends to identify opportunities for improvement and ensure operational objectives are met.
• Reporting and Data Quality Monitoring: Develop and maintain dashboards, reports, and monitoring tools that provide visibility into operational performance, verification outcomes, data quality trends, emerging risks, and opportunities for timely intervention.
• Technology and Workflow Optimization: Collaborate with product and engineering teams to define business requirements, test new features, and improve the usability, accuracy, and scalability of provider data verification tools and operational workflows.
• AI and Automation Initiatives: Help design, implement, and monitor AI agents and other automation solutions that reduce manual workloads, improve verification efficiency, and strengthen the accuracy and scalability of provider data processes.
• Root-Cause Analysis and Continuous Improvement: Investigate recurring data quality issues, identify patterns and underlying causes, and recommend process changes, tooling enhancements, or upstream improvements that prevent problems from recurring.
• Cross-Functional Business Analysis: Partner with claims teams and other internal data stakeholders to develop analyses and reporting that quantify the operational and business impact of provider data issues and support informed decision-making.
• Project Management and Operational Leadership: Manage multiple initiatives, establish structure in ambiguous situations, and adapt priorities as business requirements and member needs evolve. Translate operational insights into actionable plans and measurable improvements.
• Stakeholder Collaboration: Build effective working relationships with internal teams, offshore partners, and other stakeholders to align priorities, resolve operational challenges, and support consistent, high-quality provider data management.

Requirements

• Education and Professional Experience: Bachelor's degree and 3–5+ years of relevant experience in healthcare operations, provider data, provider directories, credentialing, claims, network operations, data quality, or a related field.
• Provider Data Operations: Demonstrated experience managing operational workflows involving provider information, record validation, data quality, research, verification, or issue remediation.
• Process Development and Optimization: Proven ability to design, document, implement, and scale repeatable operational processes with measurable improvements in quality, productivity, and efficiency.
• Analytical and Problem-Solving Skills: Strong analytical capabilities, including investigating data discrepancies, identifying patterns and anomalies, determining root causes, and translating findings into practical operational actions.
• Reporting and Performance Monitoring: Experience developing or maintaining dashboards, reports, and monitoring tools to track performance, identify operational risks, and measure data quality outcomes.
• Technical and Product Collaboration: Experience partnering with product and engineering teams to define requirements, test enhancements, troubleshoot issues, and improve operational systems and tools.
• Project and Stakeholder Management: Strong project management, organizational, and communication skills, with the ability to manage competing priorities and collaborate effectively with offshore teams and cross-functional partners.
• Adaptability and Initiative: A self-directed working style and the ability to operate effectively in a fast-paced, metrics-driven environment characterized by ambiguity, changing priorities, and evolving business needs.
• Preferred Offshore Operations Experience: Experience managing or scaling offshore teams, external vendors, or shared-services operations.
• Preferred AI and Automation Expertise: Exposure to artificial intelligence, agentic workflows, machine learning, or automation technologies, particularly in applications designed to reduce manual operational work and improve data quality.
• Preferred Data Querying Skills: SQL proficiency or equivalent technical ability to query, join, investigate, and validate provider, claims, or operational datasets directly.
• Preferred Healthcare Regulatory Knowledge: Familiarity with provider directory requirements, CMS Medicare Advantage directory accuracy expectations, or other healthcare data, network, and regulatory requirements.

Benefits

• Competitive Annual Salary: Base salary range of $73,000–$115,000, depending on qualifications, relevant experience, education, certifications, specialized skills, and work location.
• Health Insurance: Employer-sponsored medical, dental, and vision coverage with low or no premiums.
• Generous Paid Time Off: Paid leave to support personal needs, rest, and work-life balance.
• Monthly Connectivity Stipend: $100 per month toward mobile phone or internet expenses.
• Equity Opportunities: Stock options available to all employees.
• Bonus Eligibility: Eligibility for bonuses across most roles, excluding Director-level positions and above.
• Retirement Savings: Access to a 401(k) retirement savings program.
• Parental Leave: A parental leave program designed to support employees and their families.
• Remote Work: A nationwide remote work opportunity within the United States.
• AI and Technology Exposure: Opportunities to work with AI-powered tools, automation, and innovative data solutions in healthcare operations.
• Professional Development: Opportunities to strengthen expertise in healthcare data management, operational leadership, analytics, process improvement, and cross-functional project delivery.
• Meaningful Impact: The opportunity to help improve healthcare experiences by supporting accurate provider information, better care navigation, and more reliable operational processes.
• Collaborative Culture: Work in an environment that values diverse perspectives, continuous improvement, adaptability, and teamwork.
• Additional Rewards: Access to other benefits and employee programs as part of the total rewards package.