[Hiring] Quality & Accreditation Director @The Harbor Health Team

Role Description

Harbor Health is seeking a seasoned, detail-oriented Quality & Accreditation Director to lead the implementation, refinement, and oversight of a comprehensive enterprise-wide Quality Management Program supporting our Texas fully insured Individual & Family Plan (IFP/Marketplace) and large group (25+ employees) commercial products. This role will serve as our internal NCQA expert, coordinating cross-functional efforts to put NCQA-reviewed policies into practice, build the implementation evidence and performance results required for a full survey, and maintain continuous survey readiness for our health plan and applicable NCQA programs for our medical group while driving performance improvement initiatives and maintaining regulatory compliance.

Qualifications

• Bachelor's degree in Nursing, Healthcare Administration, Public Health, or a related field
• 8 years of experience in healthcare quality improvement and/or compliance within a health plan, delegated entity, or integrated delivery system
• Demonstrated experience leading and sustaining NCQA accreditation efforts for a licensed health plan or delegated entity, including direct involvement in at least one successful NCQA survey
• Strong understanding of NCQA Health Plan Accreditation standards, HEDIS, and CAHPS
• Demonstrated experience implementing and refining quality policies and procedures and documenting evidence of implementation for NCQA file review and look-back requirements
• Working knowledge of Texas commercial health plan regulation (TDI) and ACA Marketplace/QHP quality requirements
• Experience with commercial and/or Marketplace products; fully insured individual and group experience strongly valued
• 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

Requirements

• Master's degree in Healthcare Administration, Public Health, or a related field (preferred)
• Certified Professional in Healthcare Quality (CPHQ) or NCQA-related certification (e.g., NCQA Certified HEDIS Compliance Auditor, PCMH CCE) (preferred)
• Experience working in an integrated delivery system, payvider, or startup environment (preferred)
• Experience guiding a health plan from NCQA Interim status through a First survey, or leading renewal surveys (preferred)
• Experience with delegation oversight and Marketplace QRS/QHP reporting (preferred)
• Bilingual in English/Spanish (preferred)

Benefits

• Competitive salary and incentives
• Generous PTO
• 10 paid holidays
• Medical, Dental, and Vision Insurance
• 401(k) Investment Plan
• Company Equity
• Professional development and growth opportunities

Company Description

At Harbor Health, we're transforming healthcare in Texas through collaboration and innovation. We're seeking passionate individuals to help us create a member-centered experience that connects comprehensive care with a modern payment model. If you're ready to make a meaningful impact in a dynamic environment where your contributions are valued, please bring your talents to our team!

Equal Employment Opportunity

Harbor Health is an Equal Opportunity Employer. We celebrate diversity and are committed to building an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic.