Head of Quality

Antidote Health is a tech- driven health insurance company on a mission to make healthcare easy, accessible, and more affordable. We’re rethinking how healthcare works—using technology to remove the friction, complexity, and delays that define the traditional system. Instead of navigating paperwork, long waits, and disconnected experiences, we’re building a simpler, more connected way for people to get care.

Our platform combines health coverage, virtual care, and a modern member experience into one seamless system designed to help people actually use their benefits.

We offer Affordable Care Act (ACA) health plans in Arizona and Ohio, and we’re growing quickly. We’re building a company focused on solving real problems—with real impact on people’s lives.

Antidote Health Plan is seeking a strategic, executive-level Head of Quality to lead the enterprise quality vision, strategy, and performance across all state and federal programs. This role is accountable for designing, governing, and continuously improving a comprehensive quality program that drives superior clinical outcomes, member experience, regulatory performance, and accreditation results.

The Head of Quality serves as the organization’s enterprise authority on HEDIS®, CAHPS®, QHP Enrollee Survey, Secret Shopper Survey (SSS), Quality Rating System (QRS), Quality Improvement Strategy (QIS), and NCQA Health Plan Accreditation. This leader ensures that quality requirements are translated into scalable data, operational, and technology capabilities while maintaining clear separation between strategic oversight and delegated operational execution.

The role is highly cross-functional, partnering with Product, Technology, Analytics, Clinical Operations, Network, Pharmacy, and Member Services to ensure quality is embedded across all workflows and decision-making.

This position is intentionally designed as a strategic, oversight-oriented leadership role, with primary accountability for:

• Enterprise quality strategy, performance management, and governance
• Data enablement and real-time performance visibility through Technology and Analytics
• Regulatory readiness and accreditation success
• Cross-functional alignment and execution accountability

1. Enterprise Quality Strategy & Governance

• Define and execute a multi-year enterprise quality strategy aligned with regulatory requirements, accreditation standards, and organizational goals and KPIs
• Lead the annual Quality Improvement Program (QIP), including program description, work plan, performance monitoring, and evaluation
• Establish governance structures, KPIs, and reporting frameworks to track performance and outcomes
• Present quality performance, risks, and improvement initiatives to executive leadership and governing bodies
• Promote a culture of continuous quality improvement across the enterprise

2. QHP Quality Performance & Member Experience

• Lead enterprise strategy for QRS, QHP Enrollee Survey, CAHPS®, and Secret Shopper Survey (SSS)
• Oversee Quality Improvement Strategy (QIS) design, execution, and evaluation
• Translate survey and performance data into actionable initiatives to improve access, service, and care coordination
• Ensure readiness for all QHP quality reporting and performance cycles
• Establish enterprise HEDIS® strategy, timelines, and performance targets
• Provide executive oversight of HEDIS® execution, including data sources, medical record review, validation, and submission
• Analyze performance trends and lead cross-functional interventions to close gaps in care
• Ensure HEDIS requirements are translated into scalable workflows, reporting logic, and system capabilities

4. Data, Technology & Performance Enablement

• Serve as the business lead translating quality…