Senior Director, Clinical Data Governance and Integration

Job Summary: The Senior Director, Clinical Data Governance & Integration is responsible for developing, executing and coordinating enterprise clinical data governance and integration activities. This role ensures standardized business requirements, oversees governance cadence, and drives cross-functional alignment across clinical data users to support enterprise growth objectives.

Essential Functions: Leads the execution of enterprise clinical data governance and integration strategies. Establish and maintain a comprehensive clinical data inventory inclusive of data sources, attributes, ingestion pathways, ownership, downstream use cases, and refresh cadence. Develop and maintain standardized business requirement templates for clinical data acquisition.

Oversee governance activities related to acquisition opportunities and data quality performance, ensuring effective documentation, risk escalation, and decision-making. Identifies and recommends clinical data acquisition opportunities by reviewing emerging trends, regulatory changes, and competitive intelligence. Drive clinical data use cases from concept through implementation - including business case development, requirements definition, technical coordination, testing, deployment, value tracking, and post-implementation optimization.

Partner with Enterprise IT and Data Engineering to prioritize ingestion pipelines and interoperability enhancements (e.g., HL7/FHIR). Oversees performance monitoring related to clinical data vendors. Ensure governance guardrails are maintained to prevent fragmented, duplicative, or misaligned clinical data acquisition efforts across business units.

Serve as liaison between business domains and enterprise governance forums to ensure alignment with broader enterprise data strategy. Lead and develop a team of analysts responsible for data profiling, reconciliation, acquisition evaluation, quality monitoring, and roadmap support. Perform any other job related duties as requested.

Education and Experience: Bachelor's degree in Health Informatics, Public Health, Data Science, Healthcare Administration, or related field required Master's degree in related field preferred Equivalent years of relevant work experience may be accepted in lieu of required education Seven (7) years of progressive experience in healthcare analytics, clinical data integration, interoperability, or managed care operations required Five (5) years of leadership experience in a managed care or healthcare organization required Experience working cross-functionally with IT, Quality, Risk Adjustment, Care Management, and Finance stakeholders required Competencies, Knowledge and Skills: Advanced understanding of healthcare data architecture, including clinical, claims, enrollment, provider, and supplemental data domains.

Strong understanding of enterprise data platforms (e.g., data warehouses, cloud data lakes such as Snowflake, Azure, AWS, GCP). Working knowledge of SQL (ability to review queries, validate outputs, and challenge analytic logic; hands-on querying experience preferred). Knowledge of Clinical Quality entities and national interoperability frameworks, including TEFCA, QHIN participation models, HIE partnerships, and CMS-aligned data exchange initiatives.

Familiarity with healthcare interoperability standards including FHIR, HL7, CCD/CCDA, and API-based data exchange models. Skilled in overseeing ingestion, normalization, and governance of clinical data sources (HIEs, lab feeds, EMR extracts, vendor files). Strong understanding of data quality frameworks (completeness, timeliness, conformance, integrity, duplication management).

Skilled in implementing enterprise data governance models (data ownership, stewardship, lineage, metadata management). Ability to evaluate vendor technical capabilities and negotiate data delivery standards, file layouts, SLAs, and quality thresholds. Understanding of CMS Stars, HEDIS, CAHPS, Risk Adjustment, and regulatory reporting data requirements.

Familiarity with modern BI and analytics tools (Power BI, Tableau, Python/R environments) sufficient to guide strategy and challenge outputs. Skilled in reducing manual data workflows through automation and system integration. Ability to lead and influence in a highly matrixed environment.

Ability to translate technical data strategies into executive-ready business narratives. Licensure and Certification: Certifications such as CHDA, PMP, Lean Six Sigma, or advanced analytics credentials preferred Working Conditions: General office environment; may be required to sit or stand for extended periods of time Ability to travel as required by the needs of the department.

Compensation Range: $135,600.00 - $237,400.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance.

We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time.

CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-SW2 Brand=CareSource The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers.

We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we're looking for people like you that will rewrite that definition every day.

We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.