Director of Quality & Provider Engagement

Red Seal Recruiting; New York (NY); Hybrid; USD 150,000 - 180,000; Full time

Benefits offered by this job

Competitive salary

Comprehensive health benefits

Company-paid life insurance

401(k) with 6% match

13 paid holidays & PTO

Hybrid work schedule

Direct line to executive leadership

Job summary

Red Seal Recruiting in New York, NY is seeking a Director of Quality & Provider Engagement to own quality across a large value-based network and drive improvement with executive visibility. The role combines data analytics with hands-on leadership in a fast-growing IPA/ACO setting.

You will report to the Chief Medical Officer, lead Quality and Provider Engagement teams, and partner with IT, data, and finance to optimize performance and incentives. Hybrid schedule in New York.

Qualifications

• Strong analytical and problem-solving skills to turn data into insight and action.
• 5+ years in quality/HEDIS within value-based care; not hospital QA-only.
• Advanced data literacy with Excel and large data sets.
• Experience managing and developing people.

Responsibilities

• Own overall quality performance for the IPA/ACO, including HEDIS, QARR, patient satisfaction, and Star Ratings.
• Develop and drive the quality improvement strategy through data analysis, stakeholder engagement, and health-plan collaboration.
• Lead and mentor the Quality team, translating analytics into actionable improvement plans.
• Provide leadership and structure to the Provider Engagement team, operationalizing quality strategies at the practice level through provider coaching, EMR-configuration support, and feedback loops.
• Build and deepen provider relationships, and lead provider education on documentation and risk adjustment.
• Establish operational performance metrics and processes, including workload distribution and output tracking, and lead digital transformation to reduce manual reporting.
• Partner with IT, data, and finance, and support the distribution of quality incentives, risk-adjustment earnings, and shared savings.
• Own programs that improve member quality, engagement, and retention across the network.

Skills

Analytical thinking

Excel expertise

People management

Translate analysis to action

Adaptability

Job description

Director of Quality & Provider Engagement

New York, NY (Hybrid) | Full-time

S alary range: $150,000 to $180,000

We are partnering with a high-performing independent physician association (IPA) in the New York metro area that supports a large network of providers and several hundred thousand patients, a substantial share of them under value-based care arrangements. The organization is financially stable, growing, and recognized for strong quality performance. This is a rare chance to own and elevate quality across a large value-based network, with meaningful autonomy and a direct line to executive leadership.

Reporting to the Chief Medical Officer, the Director of Quality & Provider Engagement leads both the Quality and Provider Engagement functions. You will own overall quality performance across the value-based book, turn data into measurable improvement, and bring operational rigor to a fast-growing organization. This role is a fit for a strong analytical thinker and hands-on leader who is equally at home in the data and leading and developing a team.

What you'll do

• Own overall quality performance for the IPA/ACO, including HEDIS, QARR, patient satisfaction, and Star Ratings.
• Develop and drive the quality improvement strategy through data analysis, stakeholder engagement, and health-plan collaboration.
• Lead and mentor the Quality team, translating analytics into actionable improvement plans.
• Provide leadership and structure to the Provider Engagement team, operationalizing quality strategies at the practice level through provider coaching, EMR-configuration support, and feedback loops.
• Build and deepen provider relationships, and lead provider education on documentation and risk adjustment.
• Establish operational performance metrics and processes, including workload distribution and output tracking, and lead digital transformation to reduce manual reporting.
• Partner with IT, data, and finance, and support the distribution of quality incentives, risk-adjustment earnings, and shared savings.
• Own programs that improve member quality, engagement, and retention across the network.

What you'll bring

Required:

• Strong analytical and problem-solving skills, with the ability to turn complex data into insight and action.
• Quality or HEDIS performance experience under value-based care, at a managed-care plan, value-based provider organization, or ACO (not a hospital-QA-only background). Roughly 5+ years, though we weight depth of skill over tenure.
• Advanced data literacy, genuinely hands-on with Excel and large datasets to identify gaps and opportunities.
• Experience managing and developing people.
• Ability to translate quality analysis into practice-level action.
• Comfort operating in a fast-growing, less-structured environment where you help build the structure.

We value depth of skill and accomplishments over years in seat, so we encourage strong candidates to apply even if they do not meet every line above.

Preferred:

• Deep, hands-on expertise with CMS Star Ratings and HEDIS/QARR.
• Experience working with independent providers in an IPA or managed-care setting.
• Provider-engagement or provider-relations leadership experience.
• Experience implementing a CRM or building operational performance metrics from the ground up.
• Master's degree in a relevant field.
• Experience at a large IPA or ACO, or with a Medicaid-heavy population and multiple plan contracts.
• Familiarity with EMR configuration or clinical-implementation workflows.

Deliverables:

• In the first 90 days, assess current quality performance, team capabilities, and operational gaps, and deliver a prioritized improvement roadmap.
• By six months, stand up operational metrics and workload tracking, with early, measurable movement on priority measures.
• By twelve months, deliver measurable improvement in quality and value-based performance, supported by a high-functioning, well-led team.

Benefits:

• Competitive salary of $150,000 to $180,000.
• Comprehensive health benefits, including medical, dental, and vision coverage.
• Company-paid life insurance.
• 401(k) retirement plan with a 6% corporate match.
• Generous paid time off and 13 paid holidays.
• Hybrid work schedule.
• A direct line to executive leadership and the opportunity to shape quality strategy for a large, high-performing network.