Medical Director, Clinical Quality Science

NCQA is modernizing how quality is measured: moving to a portfolio that is deliberately chosen rather than accumulated, focused on outcomes and what patients and purchasers care about, built from digital clinical data, and transparent about how accurate each measure is and whether it changes care.

The Medical Director, Clinical Quality Science is NCQA's senior physician leader for clinical quality science, working alongside the CMO.

The center of the role is building a repeatable way to turn evolving clinical evidence and care-delivery realities into timely decisions about what NCQA measures, how measures should change, and whether they accurately reflect and improve care.

The role does this by strengthening and advising NCQA's existing measurement leaders and teams – through shared methods, mentoring and clearer decision rights.

On digital and AI-enabled measurement, the role is the clinical evaluator and requirements-setter, working with NCQA's informatics, product, AI, policy and partnership leaders, who own those agendas.

Key Responsibilities

1. Clinical evidence and measure decisions

Build and run a repeatable process that turns changes in guidelines, tests, therapies and care delivery (e. g., new colorectal cancer screening modalities, multi-cancer detection, CGM in diabetes, USPSTF and FDA actions) into timely, well-documented recommendations on whether and how NCQA measures should respond.

Lead structured evidence reviews and draft decision memos for the CMO, measurement committees and the Committee on Performance Measurement (CPM): new measures, revisions and retirements.

Apply NCQA's retirement and selection criteria to identify and document candidates for renovation or retirement.

• 2. Portfolio stewardship and measure fidelity
• Serve as clinical lead for the Portfolio Curation workgroup within the Modernizing Measurement initiative.

Shape clinical concepts for under-measured domains (e. g., person-centered outcomes, shared decision making, behavioral health, dementia, patient experience).

Assess whether measures accurately reflect the care delivered and whether they improve it: data-path artifacts, misattribution, gaming risk, unintended consequences and post-implementation effectiveness.

Build and coordinate a network of 'informatics partner' systems that work with NCQA to test measure feasibility and evaluate the accuracy of measure output.

• Partner with Analysis & Evaluation and Clinical Informatics on data validity and measure evaluation.
• Support the Quality Solutions Group in winning funding to build required new measures.
• 3. Strengthening QMRG methods and teams

Work through existing QMRG leaders and teams to co-develop shared methods for evidence review, clinical appraisal and fidelity assessment, and embed them in how measures are developed and maintained.

Help clarify decision rights across clinical, methodological and governance steps so that recommendations move quickly and accountability is clear.

Mentor measure developers and analysts on clinical reasoning and evidence appraisal; strengthen clinical capability across the team.

4. Clinical requirements for digital and AI-enabled measurement

Serve as clinical evaluator and requirements-setter for digital measures: which clinical data elements are reliably captured in workflow, where FHIR/USCDI and ECDS data fall short, and what accuracy is needed for a measure to be trusted at different levels of data maturity.

Define clinical evaluation criteria for AI-enabled services that could improve measurement or reduce its cost (e. g., AI-assisted chart abstraction, automated data validation), and provide clinical review of vendor evidence – in partnership with NCQA's informatics, product, AI, policy and partnership leaders, who own the digital activation and vendor-partnership agendas.

• Provide clinical input to NCQA's work with CMS and states on digital quality measures.
• 5. Clinical stakeholder engagement and thought leadership

Engage clinicians, specialty societies, health plan medical and quality leaders, and patient/consumer voices to surface the outcomes that matter and build consensus early in measure development.

Represent NCQA in technical expert panels, measure committees and federal/state discussions; present at conferences and webinars.

Support clinical framing of longer horizon work, including provider-level reporting and quality for AI use.

Draft clinical sections of white papers, funder concept notes, board and leadership materials, and peer-reviewed manuscripts.

Qualifications

Required

MD, DO or equivalent with active or prior clinical practice; board certification (primary care, internal medicine, family medicine, pediatrics or preventive medicine strongly preferred; other specialties considered).

10+ years in healthcare quality, performance measurement, guideline development, health services research or medical leadership in a health plan, health system, government agency or research organization.

Demonstrated skill in evidence synthesis and critical appraisal; comfort with measurement concepts such as reliability, validity, attribution and risk adjustment.

Track record of strengthening teams through shared methods, mentoring and clear decision processes; able to lead through influence in a matrixed organization.

Excellent writing: able to produce concise, decision-ready memos for executives and technical documents for experts.

Credibility with clinicians and plan leaders.

Preferred

MPH, MS or equivalent training in epidemiology, health services research, informatics or health policy (e. g., National Clinician Scholars, VA Quality Scholars, AHRQ/NRSA fellowship).

Experience developing or stewarding quality measures (HEDIS, CMS programs, specialty-society measures) or serving on measure/guideline committees.

Working knowledge of electronic clinical data and digital quality measurement (EHR data, FHIR/USCDI, CQL, ECDS, eCQMs).

Experience evaluating AI/ML or NLP tools in clinical or quality settings.

Peer-reviewed publication record.

Compensation & Benefits

• For new hires, this position pays in the range of $280K - $330K per year, depending on experience.
• This position is eligible for an annual incentive bonus, payable in accordance with policy.
• Click here for employee benefit information.

NCQA is committed to being an employer of choice and fostering an inclusive culture and workplace. We are an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities. NCQA is a drug free workplace.

NCQA recruits, hires, trains and promotes individuals, and administers any and all personnel actions, without regard to race, color, religion, national origin, age, sex, pregnancy, citizenship, familial status, disability status, veteran status, genetic information, or other protected statuses under applicable state and federal laws.

NCQA will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant.

However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c).