Director, Quality Programs
About The Position
Stellar Health is building its Quality function from the ground up, and this is the role that stands it up. As Director, Quality Programs, you will carry a dual mandate: first, serving as the subject matter expert and leader directly owning our Quality Program for our CMS ACO business and all risk contracts; and second, leading quality across the full Stellar business — serving as the internal quality authority for Sales, Product, Customer Success, and Operations. You will report directly into the VP, Value-Based Care Operations. This is not a back-office function. You will be embedded in commercial conversations, influencing the product roadmap, advising Customer Success on payer submissions, and representing Stellar's quality expertise in client-facing and prospect-facing settings. The right candidate brings 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 — because the nuances of this space matter, and we need someone who lives and breathes them. You will operate as an expert individual contributor from day one: running MSSP quality submissions, conducting rigorous analysis of the quality landscape, advising ACO leadership and practices on performance strategy, and representing Stellar in peer-level conversations with payer quality leadership. Internally, you will be the go-to quality resource for deal-level feasibility questions from Sales, measure logic review for Product, escalated HEDIS questions from Customer Success, and quality sign-off before anything ships. Over time, you will hire and develop a small team, transitioning from solo executor to player-coach. This is a builder role — the quality function exists in theory; you will make it real.
Requirements
- 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
- Track record of peer-level engagement with payer quality leadership, plan medical directors, or equivalent external stakeholders
- Strong leadership, communication, and interpersonal skills; able to navigate and manage relationships across all levels, both upward and downward
- A Bachelor's degree in Healthcare, Public Health, or a related field. We will sub in relevant career experience in lieu of degree
Responsibilities
- 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.
- Lead all Stellar Health ACO quality submission activity: submission package preparation, internal audits, review and sign-off cycles, and ACO leadership advisory on performance trends and contract target-setting.
- Conduct robust and regular analysis of the broader quality landscape to identify trends, surface risks, and maintain Stellar's position as a knowledgeable partner to payers and ACOs.
- Establish KPIs to measure the impact of quality interventions; report to senior leaders weekly and as needed on current performance status and emerging issues across all ACOs.
- Serve as the single internal owner of the quality SME queue — fielding and resolving "does this count?" questions from Customer Success, Provider Success, Product, Operations, and Sales without escalation.
- Establish and enforce product sign-off authority: formally review and approve quality measure logic before any measure goes into production, preventing misconfigured deployments and downstream financial consequences.
- Develop multi-year strategies for MSSP Quality performance (PY2026, PY2027, and beyond) 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.
- Lead the annual HEDIS spec review: translate NCQA updates into product and operational recommendations, including ICD/CPT/LOINC code updates and new or modified measures.
- Support deal-level measure feasibility assessments and state-by-state Medicaid quality alignment for the growth team; represent Stellar in peer-level conversations with payer quality leadership.
- 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.
- Build and manage relationships with external vendors and partners supporting quality submission processes; manage bespoke payer specifications across multiple health plans.
- 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.
- Work directly with network practices to co-design gap closure workflows; collect cross-functional feedback to support continuous process improvement.
Benefits
- Medical, Dental and Vision Benefits
- Flexible PTO
- Universal Paid Family and Caregiver Leave
- Wellhub+ Gym Memberships
- Pre-tax commuter benefits, HA, FSA plans
- Company sponsored One Medical memberships and Citibike memberships
- Medical Travel Benefits
- JOON, a flexible lifestyle spending account that gives our team a monthly stipend to spend on what matters most to them
- Stock Options & a 401k matching program
- A broad calendar of company sponsored social events that for our in-office and remote employees
- Company sponsored lunch for all NY HQ employees
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What This Job Offers
Job Type
Full-time
Career Level
Director
