Director, Data Quality & Integrity (Provider Network Operations)

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The Director, Data Quality/Integrity understands end-to-end master data processes and flows and uses that knowledge to design and implement master data management solutions. The Director, Data Quality/Integrity requires an in-depth understanding of how organization capabilities interrelate across the function or segment.

This is a remote position.

The Director, Provider Data Quality & Directory Governance is responsible for defining and executing the enterprise strategy for provider data quality, governance, directory accuracy, and innovation. This leader will establish the operating model, standards, controls, and continuous improvement practices that ensure provider data is accurate, complete, timely, compliant, and trusted across provider directories, network operations, credentialing, contracting, and digital experiences.

Reporting to the VP of Provider Network Operations, this role partners across Operations, Technology, Analytics, Compliance, Provider Services, and market leadership to improve provider data integrity, strengthen governance, reduce defects, and enhance provider and member experiences. The Director is expected to champion innovation, challenge traditional approaches, and actively collaborate both within the organization and across the healthcare industry to advance provider data management practices.

Key Responsibilities

Data Quality Strategy & Leadership

• Develop and execute a multi-year data quality and integrity strategy aligned with organizational priorities.
• Establish enterprise standards, policies, and operating models that support sustainable data quality practices.
• Lead strategic initiatives focused on improving data accuracy, completeness, consistency, and timeliness.
• Serve as a thought leader in data quality management, governance, and stewardship.

Data Governance & Data Mastering

• Lead data governance programs that define ownership, accountability, business rules, and quality standards for critical data assets.
• Partner with business and technology leaders to establish data stewardship responsibilities and governance processes.
• Oversee data mastering initiatives, including the identification, definition, and management of key enterprise data assets.
• Drive alignment across stakeholders on data definitions, standards, and quality expectations.

Data Integrity, Auditing & Controls

• Design and implement data-driven auditing programs to proactively identify data anomalies, risks, and process weaknesses.
• Establish monitoring frameworks and controls that improve visibility into data quality performance.
• Lead reconciliation and validation processes to ensure alignment across multiple data sources.
• Develop feedback mechanisms and continuous improvement processes that address root causes of data quality issues.

Operational Excellence & Process Improvement

• Conduct end-to-end assessments of business processes impacting data quality and integrity.
• Lead provider directory data quality and integrity efforts to ensure compliance with CMS requirements, including accuracy, completeness, timely updates, and audit readiness.
• Identify rework drivers, inefficiencies, and recurring quality issues and implement sustainable solutions.
• Lead continuous improvement initiatives that improve operational effectiveness and reduce data-related defects.
• Develop executive dashboards and reporting that provide actionable insights into quality performance.

Technology, Vendor & Solution Management

• Evaluate current and emerging data quality technologies and governance solutions.
• Lead vendor assessments, RFP processes, and business case development for new capabilities.
• Partner with Technology teams to implement tools that enhance automation, monitoring, and data governance.
• Assess market-leading practices and identify opportunities to improve quality management capabilities.

Stakeholder Partnership & Influence

• Build strong relationships with operational leaders, technology teams, analytics partners, and external vendors.
• Facilitate cross-functional alignment on data quality priorities and governance decisions.
• Present findings, recommendations, and strategic roadmaps to executive leadership.
• Lead organizational change efforts that promote enterprise ownership of data quality.

Use your skills to make an impact

This role is not eligible for work visa sponsorship.

Required Qualifications

• Bachelor's degree in Business, Healthcare Administration, Information Systems, Data Analytics, or a related field.
• 8+ years of leadership experience in provider data management, provider directory operations, data governance, data quality, network operations, or related healthcare functions.
• Deep understanding of provider data domains, including directory data, demographics, affiliations, specialties, credentialing, contracting, and regulatory requirements.
• Experience designing and implementing enterprise data governance frameworks, stewardship models, quality controls, and auditing programs.
• Proven success leading large-scale cross-functional transformation initiatives across business and technology organizations.
• Strong executive presence with the ability to influence stakeholders and translate complex data issues into business outcomes.

Preferred Qualifications

• Master's degree in a related field.
• Experience with provider directory accuracy programs, regulatory audits, accreditation requirements, and provider network operations.
• Experience with master data management, data governance platforms, and data quality tools.
• Lean, Six Sigma, Data Governance, or Data Management certifications.

Work at Home Requirements: To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$156,600 - $215,400 per yearThis job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.Application Deadline: 10-29-2026

About us

About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.