Director/Manager - Provider Data Management Solutions

Santech Solution Inc is seeking an experienced Provider data management Solution expert with strong software usage experience to lead provider data management solutioning initiatives, within the healthcare payer domain to join our team in Princeton, NJ.

The ideal candidate will possess expertise in provider lifecycle management, provider data governance, network management, healthcare operations, cloud-based SaaS platforms, and healthcare payer systems.

This role involves working closely with business stakeholders, clients, delivery teams, and technology partners to design scalable, configurable, and cloud-enabled provider data management solutions that improve operational efficiency, data quality, compliance, and provider experience.

Solutioning & Strategy

• Lead Provider Data Management (PDM) solution design and implementation initiatives.
• Assess current-state provider operations and define future-state transformation roadmaps.
• Develop scalable and compliant provider lifecycle management solutions.
• Design operating models, workflows, and governance frameworks for provider data management.
• Support strategic initiatives related to provider onboarding, credentialing, contracting, maintenance, and directory management.

Business & Client Engagement

• Collaborate with healthcare payer clients to understand business requirements and operational challenges.
• Translate business requirements into functional and technical solution designs.
• Present solution recommendations, implementation plans, and business value propositions to leadership teams.
• Support proposal development, RFP responses, estimations, and solution presentations.

Provider Data & Operations

• Drive initiatives focused on provider data accuracy, standardization, and regulatory compliance.
• Improve provider data quality, turnaround times, and operational efficiency.
• Define KPIs, SLAs, and reporting mechanisms for provider operations.
• Technology, SaaS & Integration
• Work with IT and architecture teams to define integration requirements, SaaS platform configurations, and system enhancements.
• Support implementation and optimization of SaaS-based PDM platforms and healthcare payer applications.
• Collaborate on data migrations, workflow automation, interoperability, and digital transformation initiatives.
• Provide guidance on data governance, and provider directory solutions.

Leadership & Collaboration

• Mentor business analysts, SMEs, and project teams.
• Coordinate cross-functional teams across business, operations, and technology.
• Support change management and organizational adoption activities.
• Participate in continuous improvement and innovation initiatives.

Required Qualifications

• Master’s (Preferred)/Bachelor's degree in healthcare administration care administration, Business, Information Systems, or related fields.
• 12+ years of experience in healthcare payer operations or provider data management.
• Strong understanding of provider lifecycle management processes.
• Experience with healthcare payer systems, provider platforms, and workflow tools.
• Knowledge of healthcare regulations
• Strong analytical, communication, and stakeholder management skills.
• Experience in solution design, business process transformation, and consulting engagements.

Preferred Qualifications

• Experience with PDM platforms and provider directory solutions.
• Knowledge of Claims Systems (Facets, QNXT, Healthedge) or similar payer platforms.
• Pay range: $150,000-$300,000 (includes Base, Bonus, Benefits, Stock options etc.)