In this role, the clinician leads provider quality, documentation integrity, and payor audit readiness across a large behavioral health provider network. The work centers on defining clinical standards, reviewing documentation compliance, and guiding quality review and escalation decisions. It also includes cross-functional collaboration with operations, product, and payor partnership teams to ensure clinical requirements are reflected in workflows and deliverables.
Key Responsibilities
- Lead and develop a clinical quality team by setting expectations, managing performance, and supporting independent problem-solving.
- Define and maintain the clinical standard for provider quality review, escalation, and termination decisions.
- Own documentation integrity standards and identify compliance gaps that affect payor audit readiness.
- Review cross-functional initiatives for clinical soundness and recommend adjustments before implementation.
- Collaborate with Clinical Operations, Product, Operations, and Payor Partnerships to translate clinical requirements into actionable workflows.
- Assess provider quality outcomes and documentation processes across a large behavioral health network.
- Surface blockers and drive resolution across branch workstreams with a clear recommended path forward.
Required
- Active, unrestricted clinical license such as LCSW, LMFT, LPC, PsyD, PhD, or equivalent.
- 5-7 years of clinical quality experience.
- Direct experience managing a clinical quality team.
- Experience with payor audit response, documentation compliance reviews, or clinical documentation standards in behavioral health.
- Ability to translate clinical standards and documentation requirements for non-clinical partners.
Preferred
- Experience working in a behavioral health context.
- Experience partnering with product and operations teams on clinical workflow design.
- Experience advocating for clinical standards in cross-functional settings without final decision authority.
Benefits & Perks
- Fully remote or hybrid work options.
- Hybrid schedule with onsite work three days per week at a hub location.
- Travel 2-3 times per year for company and department offsites.
- Medical, dental, vision, life, and disability coverage.
- Up to 18 weeks of paid parental leave and a new child stipend.
- 401(k) program and equity opportunities.
- Home office and meal stipends, plus flexible PTO, paid holidays, and a winter break week.
- Annual stipends for personal and professional growth, plus no-cost access to therapy and wellness app memberships.