Director – Data Abstraction and Operations

Director – Data Abstraction and Operations

Requirements

• Minimum 10 years of relevant healthcare experience, with at least 5 years in data abstraction, clinical/commercial operations, or health informatics.
• At least 5 years in a leadership role.
• Advanced clinical degree (e.g., MD, PhD, PA, MSN, NP, etc…) required; additional degrees in Health Informatics, Data Science, or related fields strongly preferred.
• Experience with AI/ML applications in clinical workflows, including natural language processing (NLP) and clinical decision support systems.
• Familiarity with coding languages (SQL / python / data programming languages).
• Proven success leading high-performing teams and managing complex and cross functional operational programs.

Responsibilities

• Lead the clinical data abstraction team, setting clear goals, performance metrics, and strategic direction.
• Develop and implement scalable abstraction workflows aligned with clinical quality standards, billing accuracy, and product development needs.
• Collaborate cross-functionally with Clinical, Revenue Cycle, Data Science, Engineering, and Product teams to align abstraction strategies with organizational objectives.
• Partner with data science and engineering teams to evaluate and implement AI-assisted abstraction tools, leveraging large language models and workflow automation tools.
• Ensure AI models align with clinical logic, billing integrity, and data reliability.
• Maintain continuous feedback loops with our AI/ML engineering teams to improve AI performance, reduce manual abstraction burden, and make product UI improvements.
• Oversee daily operations related to data abstraction, quality assurance (potentially leveraging AI to support), and team KPI performance.
• Design and refine SOPs, protocols, and escalation pathways to ensure consistency and operational excellence, incorporating guidelines and best practices such as the FDA guidance for use of RWE.
• Monitor productivity, turnaround times (TAT), and abstraction accuracy across multiple products with varying goals.
• Collaborate with revenue cycle teams to ensure abstracted clinical data supports accurate coding, billing, and claims submissions.
• Incorporate the data needs of other teams into the teams deliverables to reduce redundancy and ensure data usability across the organization.
• Provide high-quality, abstracted data to inform the development and improvement of clinical and digital health products.
• Partner with product managers and clinical strategy teams to ensure data abstractions support evidence generation, feature design, and customer outcomes.
• Translate abstracted clinical insights into scalable datasets that support real-world evidence and product differentiation.
• Ensure all abstraction processes comply with HIPAA, CAP, CLIA, CMS, AJCC staging guidelines, and payer-specific guidelines.
• Lead quality control programs and audits to maintain the highest standards of data accuracy and regulatory alignment.
• Oversee onboarding and continuous training of abstraction staff with a focus on clinical depth, documentation accuracy, and billing awareness.

Preferred Qualifications

• Deep understanding of clinical documentation, medical terminology, and coding systems (ICD, CPT, SNOMED).
• Strong analytical and strategic thinking skills, with ability to connect clinical workflows to business goals.
• Excellent communication, leadership, and change management skills.
• Ability to navigate ambiguity, drive innovation, and scale operations in a fast-paced environment.