Director Data Operations

This role drives the organization's healthcare interoperability strategy by championing seamless, bidirectional clinical and administrative data exchange between Highmark and its provider network. The flow of data supports core health plan operations, including case management, utilization management, risk programs, government quality programs, and claims processing. The incumbent ensures the availability, performance, and stability of processes that create, store, and deliver data for internal and external stakeholders.

Responsibilities

• Lead the strategic roadmap and execution for healthcare data exchange, leveraging deep expertise in both payer and provider technology ecosystems (e.g., EHR/EMR platforms like Epic and Oracle) to bridge technical and operational gaps.
• Ensure robust data integration utilizing modern healthcare standards (e.g., HL7 V2, FHIR) to directly support and improve clinical workflows, population health initiatives, and payer-provider alignment.
• Perform management responsibilities, including hiring and termination decisions, coaching and development, rewards and recognition, performance management, and staff productivity.
• Plan, organize, staff, direct, and control the day-to-day operations of the department; develop and implement policies and programs as necessary; may have budgetary responsibility and authority.
• Monitor, maintain, and support the operational and analytic data platforms and technology, working closely with IT partners to ensure the group leverages the latest tools and technology.
• Oversee an efficient and effective quality control process that tests and reviews all code and processes to ensure accuracy.
• Create an overall production and continuous improvement discipline that delivers on quality while continuously lowering the cost to deliver.
• Support data and analytic end-users and stakeholder needs for appropriate data access, awareness, understanding, and troubleshooting to ensure successful information delivery.
• Reliably deliver all assets within the production environment (e.g., data sources, curated datasets, APIs, data feeds, analytic & business intelligence tools) on a timely and accurate basis.
• Act as the liaison to the organization’s broader data governance processes, data engineering teams, and other key information technology partners. Serve as a critical link to IT and external plan partners leveraging analytical tools.
• Other duties as assigned or requested.

Requirements

• Bachelor’s Degree in Information Technology, Computer and Information Science, Computer Engineering, Health Informatics, or a related field. Six years of relevant work experience may substitute for the degree.
• 7 years in Data Analytics.

Qualifications

• 10+ years of dedicated experience in healthcare interoperability and clinical data exchange (preferred).
• 15+ years in Healthcare IT delivery, with significant foundational experience on the provider side combined with strategic experience on the payer side (preferred).
• 5+ years shaping and executing healthcare technology strategy (preferred).
• Master’s Degree in Information Technology, Computer and Information Science, Computer Engineering, or a related field (preferred).

Skills

• Healthcare Interoperability (HL7, FHIR, APIs)
• Clinical Data Exchange & Integration Engines
• Healthcare IT Strategy & Delivery
• Payer & Provider Ecosystem Alignment
• Health Plan Operations (Utilization Management, Risk, Claims)
• EHR/EMR Platform Integration
• Healthcare Information Systems
• Health Information Management
• Talent Management
• IT Operations

Pay

Pay Range Minimum: $129,100.00

Pay Range Maximum: $214,500.00

Base pay is determined by a variety of factors, including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based on comparative markets.

Schedule

• Position type: Office-Based
• Travel required: 0% - 25%
• Physical work site required: Yes