Director of Quality & Credentialing Operations

CertifyOS; United States; Remote; USD 150,000 - 210,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

Unlimited PTO

Well-being benefits (including in-IND)

Job summary

CertifyOS is seeking a Director of Quality Operations to own the quality of provider data, workflows, and outcomes at scale. You will lead a central quality team, drive NCQA compliance, and serve as the senior voice for client stakeholders in credentialing and delegation oversight.

You will transform audit findings into product and automation changes, manage daily throughput, establish dashboards, and partner with Product, Engineering, and Data to push quality improvements across the

Qualifications

• A genuine obsession with quality in data, in work, and in outcomes.
• A proven track record driving quality at scale with measurement, audit, and feedback systems.
• Strong data-driven decision making with dashboards and root-cause analysis.
• Deep credentialing expertise including primary source verification and delegation audits.
• Experience leading audit/QA functions at production scale and interfacing with Product/Engineering.

Responsibilities

• Own quality as the standard across data surfaced to clients and work quality of credentialing files.
• Define measurable quality standards, baselines, and targets for various workflows and teams.
• Drive quality improvements using data to identify high-risk clients and processes.
• Build a culture of quality with clear standards, fast feedback, and accountability.
• Lead the central quality team and evolve the audit program (sampling, scoring, reporting).
• Turn audit findings into product/automation changes (validation rules, workflows, system controls).
• Oversee NCQA compliance readiness, evidence, surveys, and remediation.
• Manage daily audit throughput, throughput targets, and dashboards.

Skills

Quality management

Data-driven decision making

Executive presence

Healthcare operations experience

Leadership

Audit & QA experience

NCQA knowledge

Tools

SQL

BI dashboards

Workflow analytics

Primary source verification

Job description

CertifyOS is seeking a Director of Quality Operations to own the quality of provider data, workflows, and outcomes at scale. You will lead a central quality team, drive NCQA compliance, and serve as the senior voice for client stakeholders in credentialing and delegation oversight.

You will transform audit findings into product and automation changes, manage daily throughput, establish dashboards, and partner with Product, Engineering, and Data to push quality improvements across the