Director, Quality Programs
About the role
The right candidate will bring expertise in MSSP Quality performance, data ingestion, and client-facing engagement, combined with a genuine passion for and deep understanding of value-based care quality improvement.
Areas of Expertise and Impact
Execution & Performance Management: Independently own day-to-day execution of the MSSP Quality program, including inter-team coordination and submission workflows across HEDIS, CMS Stars, MIPS, and Medicaid quality programs.
Strategy & Reporting: Develop multi-year strategies for MSSP Quality performance in partnership with senior leadership across Strategic Initiatives, Product, and Customer Success. Lead risk mitigation strategy for MSSP quality, including performance improvement planning, technical solutioning, and input into relevant policy positions.
Data & Audit: Own all supplemental data submission workflows, including chart retrieval, data integrity checks, and PSV audit protocols; serve as sign-off authority before any supplemental data submission reaches a payer.
Partnership & Product Collaboration: Build and maintain strong relationships with key internal stakeholders — Product, Analytics, Operations, and Customer Success — to drive collective quality outcomes. Partner with EPD on PRD review for quality actions and EHR data acquisition; evaluate Stellar product functionality against CMS final rules and Stars technical specs.
Qualifications
At least 10 years of experience in healthcare, with the majority in quality program management at a provider, ACO, or health plan
At least 6 years of direct, hands-on management of end-to-end quality submissions — including expert-level understanding of MSSP quality program policies, measures, and reporting requirements
Expert-level knowledge of HEDIS, MIPS, eCQMs, MSSP ACO quality reporting, and CMS Stars — able to resolve measure-level questions cold without escalation
Demonstrated ability to build a quality function or program from scratch, not just operate within an established one
Relentless focus on data: uses numbers to guide strategic decisions; mastery of Excel/Google Sheets and PowerPoint/Google Slides
Technical experience with EHR integrations or other data source integrations; fluency in how quality measure data flows through structured EHR documentation (Epic + at least one other platform)
Proven ability to lead through influence — building alignment across senior leaders, cross-functional teams, and external stakeholders without formal authority
Deep familiarity with NCQA supplemental data standards, PSV audit protocols, and payer-specific submission requirements
Proven ability to lead through influence — building alignment across senior leaders, cross-functional teams, and external stakeholders without formal authority
Strong leadership, communication, and interpersonal skills; able to navigate and manage relationships across all levels, both upward and downward
Bachelor's degree in Healthcare, Public Health, or a related field. We will sub in relevant career experience in lieu of degree