Director of Quality

CertifyOS is building the data infrastructure that powers modern healthcare. Its API-first platform automates provider licensing, enrollment, credentialing, and network monitoring by connecting directly to hundreds of primary data sources. The Director of Quality Operations is accountable for the quality of everything CertifyOS delivers, including the accuracy of the provider data it builds, the work teams do to build it, and the healthcare outcomes that depend on both. The role leads a central quality team that audits CertifyOS's work, drives quality through measurement, root cause analysis, and workflow and technology changes, owns NCQA compliance and delegation oversight, and serves as the senior compliance and quality voice with client stakeholders. It is an operating role accountable for daily audit throughput and turnaround time.

Responsibilities

Own quality as the standard for how CertifyOS works, across data quality and work quality; define measurable quality metrics, error taxonomies, baselines, and targets by client, workflow, and team; drive quality up at scale using data to find error origins and high-risk clients and workflows; build a culture of quality across Operations; lead and grow a central quality team that conducts internal audits of credentialing files and processes; iteratively improve the audit program, including sampling, scoring, error taxonomy, calibration, and reporting; turn audit findings into root causes and product or automation changes; work with Product, Engineering, and Data to specify, prioritize, and validate changes and confirm error rates fell; manage daily audit throughput and turnaround time, including capacity planning, work allocation, and staffing; run the team on data through dashboards and operating cadence; hire, develop, and hold a high performance bar for auditors and team leads; own CertifyOS's NCQA certification posture, including readiness, evidence, survey preparation, and remediation; interpret NCQA standards into testable requirements; monitor changes to NCQA standards, client requirements, and regulation; own the delegation program with health plan clients, including delegation agreements, oversight schedules, and annual and ad hoc delegation audits; track delegated-function performance and lead corrective action plans

Requirements

10+ years in healthcare operations, quality, or compliance; 5+ years leading teams; direct ownership of throughput and turnaround-time targets; genuine obsession with quality in data, work, and outcomes; record of driving quality at scale with before-and-after results; strongly data-driven, with root cause analysis, sampling and scoring design, and dashboard use; deep credentialing expertise, including primary source verification, recredentialing cycles, and common failure modes; experience running an audit or QA function at production scale, including sampling, scoring, calibration, and root cause analysis; enough technical fluency to work with Product and Engineering, write clear requirements, and judge automation or system controls; hands-on knowledge of NCQA credentialing standards and how they are audited; experience with delegation, either overseeing delegates at a health plan or being overseen as a delegated credentialing organization or CVO; executive presence with health plan compliance officers and senior client leaders; strong written and verbal communication and judgment to escalate issues early

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, such as provider network management or utilization management standards; familiarity with URAC, The Joint Commission, CMS, and state credentialing requirements; familiarity 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 for US-based team, with at least two weeks off each year