Clinical Quality Manager – Medication Care

This is a fully remote position, open to applicants in United States.

📋 Description

• Drive and uphold exceptional clinical quality standards for Medication Providers.

• Investigate Quality of Care issues by examining member complaints, provider documentation, and internal quality metrics.

• Identify suitable provider remediation, interventions, escalations, and corrective actions.

• Collaborate with Medication Prescribers to gather information, deliver performance coaching, reinforce policies and quality standards, and foster quality improvement.

• Conduct compliance audits following interventions and monitor ongoing compliance gaps.

• Analyze and report on quality trends, recurring performance issues, and provider performance metrics.

• Oversee the annual peer review program for all Medication Prescribers.

• Maintain and enhance peer review tracking systems and documentation processes.

• Implement peer review findings and facilitate initiatives for provider performance enhancement.

• Act as a quality subject matter expert in Medication Management and a cross-functional liaison.

• Create educational materials, slide presentations, onboarding resources, continuing education, and professional development documentation.

• Identify deficiencies in Medication Management policies and procedures and revise the policy manual accordingly.

• Collaborate with Legal/Compliance, Provider Operations, Clinical Operations, Credentialing, Clinical Product, Business Intelligence, and other stakeholders on quality investigations, initiatives, operational projects, and system development.

⛳️ Requirements

• Behavioral Health Technician, Medical Assistant, LPN, RN, or a comparable direct care delivery role in behavioral health.

• 3–5 years of experience in fast-paced direct healthcare, technology, or clinical research environments.

• Active LPN, RN, or NP license with a minimum of 3 years of clinical experience in behavioral health, psychiatric care, medication management, or similar healthcare settings.

• Proficient in medical terminology, common medications, and behavioral health conditions.

• Experience collaborating directly with medical providers to deliver high-quality care.

• Background in supporting provider populations prescribing psychiatric medications.

• Familiarity with behavioral health quality assurance, provider performance management, clinical operations, or healthcare quality improvement.

• Strong understanding of clinical documentation standards, provider quality oversight, and behavioral healthcare compliance requirements.

• Experience in developing, maintaining, or enhancing operational workflows, reporting systems, dashboards, or quality tracking tools.

• Proficient in creating provider-facing educational materials, onboarding resources, operational guidance, or training documentation.

• Excellent written and verbal communication skills.

• Strong organizational capabilities and attention to detail; adept at managing multiple concurrent workstreams and operational priorities.

• Ability to excel in a dynamic and evolving environment with shifting priorities and operational ambiguity.

• Collaborative, solutions-oriented, and operationally minded approach to problem-solving.

• Interest in utilizing AI-enabled tools, workflow automation, and system enhancements.

• Experience with ZenDesk, SalesForce, or similar customer service platforms is an advantage.

• Understanding of mental health and the broader U.S. healthcare system.

• Global health experience is a plus.

• Preferred: tele-behavioral health or EAP experience; involvement in peer review initiatives; support for accreditation and regulatory bodies.

🏝️ Benefits

• Equity.

• Health, Dental, and Vision benefits commence on your first day.

• One Medical accounts.

• HSA and FSA plans, with Spring contributing up to $1K for HSAs depending on plan type.

• Employer-sponsored 401(k) match of up to 2%.

• Yearly allocation of no-cost visits to Spring Health therapists, coaches, and medication management providers for employees and their dependents.

• Paid time off including vacation, sick leave, and company holidays.

• Parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents after 6 months of tenure.

• Noom weight management program.

• Carrot fertility care support and a $4,000 reimbursement for related fertility expenses.

• Wellhub subscription for fitness, mindfulness, nutrition, and sleep.

• BrightHorizons sponsored child care, back-up care, and elder care.

• Up to $1,000 annual professional development reimbursement.

• $200 per year donation matching.

• Fully remote work arrangement.

• Occasional travel for team or company events/meetings.