Director of Quality - CertifyOS

About CertifyOS

CertifyOS is building the data infrastructure that powers modern healthcare. Today, healthcare organizations rely on fragmented and outdated provider data, creating unnecessary administrative work, regulatory risk, and higher costs across the system. We’re solving that problem.

Our API-first platform automates provider licensing, enrollment, credentialing, and network monitoring by connecting directly to hundreds of primary data sources. We help healthcare organizations maintain accurate, compliant, and reliable provider networks at scale.

Our vision is simple: One API. One provider ID. Frictionless provider data.

About the role

Quality is the job. The Director of Quality Operations is accountable for the quality of everything CertifyOS delivers: the accuracy of the provider data we build, the work our teams do to build it, and the healthcare outcomes that depend on both.

You will lead a central quality team that audits our own work every day, using findings to raise quality at scale by measuring metrics, finding root causes, and changing workflows and technology to prevent errors rather than just catching them.

Alongside that, you will own CertifyOS's NCQA compliance and delegation oversight, and serve as the credentialing expert in front of senior client stakeholders. This is a hands-on operating role where you will be accountable for daily throughput, turnaround time, and serving as the senior compliance and quality voice for CertifyOS with client stakeholders.

What you'll own

Quality at scale: data, work, and outcomes

• Own quality as the standard for how CertifyOS works, spanning data quality of what is surfaced to clients and work quality (credentialing files done right the first time).
• Define what good looks like in measurable terms: quality metrics, error taxonomies, baselines, and targets by client, workflow, and team, reported to leadership and clients.
• Drive quality up at scale by using data to find where errors originate and applying system-wide fixes.
• Build a culture of quality across Operations with clear standards, fast feedback, and accountability.

A central quality team and audit engine

• Lead and grow a central quality team that conducts internal audits of credentialing files and processes.
• Iteratively evaluate and improve the audit program: sampling methodology, scoring, error taxonomy, calibration, and reporting.
• Improve the audit process itself, including coverage, consistency, and cost per audit.

Closing the loop into technology

• Turn audit findings into root causes and translate them into product and automation changes (validation rules, workflow logic, primary-source integrations, and AI-powered workflows with human-in-the-loop).
• Work with Product, Engineering, and Data to specify, prioritize, and validate those changes.
• Use judgment about what technology can and cannot solve versus process, training, or policy.

Operational performance of the quality function

• Manage daily audit throughput and turnaround time with capacity planning, work allocation, and staffing to volume.
• Run the team on data using dashboards, daily and weekly operating cadences, and clear escalation paths.
• Hire, develop, and hold a high performance bar for auditors and team leads.

NCQA compliance

• Own CertifyOS's NCQA certification posture end to end, including readiness, evidence, survey preparation, and remediation of findings.
• Interpret NCQA standards and translate them into concrete, testable requirements for our credentialing operations and platform.
• Monitor changes to NCQA standards, client-specific requirements, and regulations.
• Ensure each new requirement is implemented in day-to-day workflows with clear owners and effective dates.

Delegation management and oversight

• Own the delegation program with health plan clients: delegation agreements, oversight schedules, and annual and ad hoc delegation audits.
• Track delegated-function performance against client and NCQA expectations, and lead corrective action plans from finding through closure.

What you'll need

• A genuine obsession with quality in data, work, and outcomes.
• A record of driving quality at scale in a high-volume operation.
• Strongly data-driven background with experience building measurement, audit, and feedback systems.
• Deep credentialing expertise, including primary source verification, recredentialing cycles, and common failure modes.
• Experience running an audit or QA function at production scale.
• Technical fluency to work with Product and Engineering to write clear requirements and judge automation controls.
• 10+ years in healthcare operations, quality, or compliance, including 5+ years leading teams with direct ownership of throughput and turnaround-time targets.
• Hands-on knowledge of NCQA credentialing standards and how they are audited.
• Experience with delegation from either side (health plan oversight or delegated credentialing organization/CVO).
• Executive presence with strong written and verbal communication skills.

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, state credentialing requirements, and 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.

Benefits

• 100% coverage of health, dental, and vision insurance premiums for employees.
• Unlimited PTO with at least two weeks off each year to recharge.