Director of Quality & Accreditation

Director Of Quality & Accreditation

Harbor Health is seeking a dynamic, detail-oriented Director of Quality & Accreditation to lead the development, implementation, and oversight of a comprehensive enterprise-wide Quality Management Program. This role will serve as our internal NCQA expert, coordinating cross-functional efforts to ensure successful accreditation for both our health plan and medical group while driving performance improvement initiatives and maintaining regulatory compliance. Reporting to the Senior Director of Compliance, this position is critical to establishing Harbor Health's foundation for quality excellence as we scale our payvider model in Austin.

Position Duties & Responsibilities

NCQA Accreditation & Readiness Lead all aspects of NCQA accreditation planning and execution, including initial and ongoing accreditation efforts. Interpret and apply NCQA standards across the organization, developing and maintaining comprehensive compliance documentation and tracking tools. Oversee all submission processes and ensure organizational readiness for reviews. Conduct gap analyses, establish detailed project plans, and serve as the primary liaison for NCQA and regulatory audits while maintaining accreditation timelines and monitoring overall status.

Quality Program Leadership Design and manage Harbor Health's enterprise-wide Quality Management Program (QMP), ensuring alignment with state and federal regulations and NCQA standards. Manage the Policy and Procedure Library, facilitating Quality Committees and ensuring proper documentation of all activities. Lead annual evaluations and performance reporting to demonstrate continuous quality improvement across the organization.

Data & Performance Monitoring Partner with analytics teams to track, interpret, and report on quality metrics and performance indicators. Support the establishment and monitoring of benchmarks in HEDIS, CAHPS, member complaints, access to care, and care coordination to drive measurable improvements in member outcomes and organizational performance.

Cross-Functional Coordination Collaborate with departments across Harbor Health to implement aligned quality initiatives that support our integrated payvider model. Ensure delegated entities and partner organizations meet NCQA performance expectations and maintain quality standards consistent with Harbor Health's mission.

Staff Supervision & Training Supervise NCQA project staff and quality personnel, providing mentorship and oversight for talent development in quality-related roles. Develop and deliver comprehensive NCQA training across all departments, providing onboarding and ongoing education on NCQA and regulatory quality standards throughout the enterprise.

Desired Professional Skills & Experience

Required Qualifications

• Bachelor's degree in Nursing, Healthcare Administration, Public Health, or related field
• 7+ years of experience in healthcare quality improvement or compliance
• Demonstrated experience leading accreditation efforts for a licensed health plan or delegated entity
• Strong understanding of NCQA Health Plan Accreditation standards, HEDIS, and CAHPS
• Proven success in leading cross-functional quality initiatives and managing complex projects
• Excellent communication, organizational, and analytical skills
• Mission-driven with passion for improving health outcomes in underserved communities
• Collaborative approach with ability to work effectively across teams, disciplines, and partners
• Results-oriented focus on measurable impact, compliance, and sustainable processes
• Adaptable and able to thrive in a dynamic, fast-paced healthcare environment

Preferred Qualifications

What We Offer