Director of Quality

The role

The Director of Quality Operations is accountable for the accuracy of provider data and the quality of work delivered by CertifyOS. You will lead a central quality team, manage NCQA compliance, and own delegation oversight for health plan clients.

What you will do

• Own quality standards for provider data and work quality
• Define quality metrics, error taxonomies, and targets
• Use data to find root causes and drive quality at scale
• Lead and grow a central quality team that conducts internal audits
• Improve the audit program including sampling and scoring
• Turn audit findings into product and automation changes
• Manage daily audit throughput and turnaround time
• Own NCQA certification posture including readiness and survey preparation
• Own the delegation program with health plan clients
• Lead corrective action plans from finding through closure

Required qualifications

• Obsession with quality in data, work, and outcomes
• Record of driving quality at scale
• Strongly data-driven
• Deep credentialing expertise
• Experience running an audit or QA function at production scale
• Technical fluency to work with Product and Engineering
• 10+ years in healthcare operations, quality, or compliance
• 5+ years leading teams with direct ownership of throughput and turnaround-time targets
• Hands-on knowledge of NCQA credentialing standards
• Experience with delegation from either side
• Executive presence
• Strong written and verbal communication

Nice to have

• Prior experience at a credentialing verification organization (CVO), a delegated health plan credentialing department, or a credentialing technology company
• NCQA experience beyond credentialing
• Familiarity with URAC, The Joint Commission, CMS, and state credentialing requirements, and with SOC 2 or HITRUST audits
• Experience using data tools to monitor quality, such as SQL, BI dashboards, or workflow analytics
• Experience in a scaling startup where processes were being built as the company grew

Benefits

• 100% coverage of health, dental, and vision insurance premiums for employees
• Unlimited PTO with at least two weeks off each year for US-based team
• Health insurance for employees in India
• Statutory leave benefits in India
• Additional wellness (menstrual) leave for women in India

About the company

CertifyOS is building the data infrastructure that powers modern healthcare through an API-first platform that automates provider licensing, enrollment, credentialing, and network monitoring.