Director of Quality

🕒 il y a 23 jours

🇺🇸 États-Unis – Télétravail

⏰ Temps Plein

🔴 Expert

👔 Directeur

👻 Score fantôme 11%

Ce que ça veut dire : la probabilité que personne ne recrute vraiment pour cette offre.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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CertifyOS

Site WebLinkedInTous les Emplois

201 - 500 employés

Fondée en 2021

🏥 Santé

☁️ SaaS

🤝 B2B

💰 €40 000 000 Series B - Certify en 2025-06

Healthcare • SaaS • B2B

CertifyOS est une plateforme de données de fournisseurs axée sur la santé qui consolide et vérifie les informations des fournisseurs pour créer une source unique de vérité activée par l'IA. Elle remplace les tableurs et les solutions ponctuelles par une infrastructure pour la gestion des accréditations, des contrats, des paiements, de la conformité et des données des fournisseurs, offrant des services tels que l'accréditation, la délivrance de licences, la surveillance et la gestion des listes. La plateforme intègre des listes et des flux en temps réel, valide les dossiers par rapport à des milliers de sources et délivre un flux de données continu et propre accessible via une API unique. CertifyOS se positionne comme une solution SaaS B2B pour les régimes de santé, les entreprises de santé numérique et les systèmes de santé, revendiquant des améliorations opérationnelles mesurables (par exemple, réduction des coûts de réaccréditation, intégration plus rapide) et comptant d'importants régimes de santé parmi ses clients.

Description

• Own quality standards across provider data quality and credentialing work quality • Define quality metrics, error taxonomies, baselines, and targets by client, workflow, and team • Report quality metrics to leadership and clients • Identify error origins, high-risk clients and workflows, and high-impact fixes • Build a culture of quality across Operations through standards, feedback, and accountability • Lead and grow a central quality team conducting internal audits of credentialing files and processes • Improve audit sampling methodology, scoring, error taxonomy, calibration, reporting, coverage, consistency, and cost per audit • Translate audit findings into root causes and product or automation changes • Collaborate with Product, Engineering, and Data on requirements, prioritization, validation, and follow-up audits • Manage daily audit throughput and turnaround time through capacity planning, work allocation, and staffing • Run dashboards, daily and weekly operating cadences, and escalation paths • Hire, develop, and maintain 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 and translate them into testable requirements for credentialing operations and the platform • Monitor NCQA standards, client-specific requirements, and regulatory changes • Implement new requirements through SOP updates, training, checklists, and system configuration • Verify post-launch adherence in practice • Own delegation programs with health plan clients, including agreements, oversight schedules, and delegation audits • Track delegated-function performance and lead corrective action plans through closure • Serve as senior compliance and quality voice with client stakeholders and credentialing committee leaders

🎯 Exigences

• Genuine obsession with quality in data, work, and outcomes • Record of driving quality at scale, including building measurement, audit, and feedback systems that reduced error rates • Strongly data-driven; able to find root causes with data, design sampling and scoring, build and use dashboards, and make decisions based on numbers • Deep credentialing expertise, including provider file creation, verification, committee review, 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 • Technical fluency sufficient to read workflows, write clear requirements, and evaluate automation and system controls • 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 and how they are audited • Experience with delegation from either side: 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 • Judgment to escalate the right issues early • Nice to have: experience at a CVO, delegated health plan credentialing department, or credentialing technology company • Nice to have: NCQA experience beyond credentialing • Nice to have: familiarity with URAC, The Joint Commission, CMS, state credentialing requirements, SOC 2, or HITRUST audits • Nice to have: experience with SQL, BI dashboards, or workflow analytics • Nice to have: experience in a scaling startup

🏖️ Avantages

• 100% coverage of health, dental, and vision insurance premiums for employees • Unlimited PTO for US-based team members, with at least two weeks off each year to recharge • Health insurance for employees in India • Statutory leave benefits for employees in India • Additional wellness (menstrual) leave for women in India • Equal employment opportunity and inclusive work environment • Reasonable accommodations during the application process

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