Director of Clinical Quality

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

📋 Description

• Design and manage patient safety initiatives, safety reporting programs, and continuous clinical care improvement initiatives based on safety data, audit results, and peer review findings.

• Ensure oversight of clinical care standards across various disciplines — including therapy, dietary, medical, and psychiatry — aligning with evidence-based standards for eating disorder treatment.

• Collaborate with discipline-specific leaders and the Compliance team to develop and uphold clinical practice guidelines and documentation standards.

• Direct clinical incident investigations and root cause analyses in partnership with the Compliance team, formulating and executing risk mitigation strategies while monitoring patterns to identify systemic trends.

• Draft and update clinical policies and procedures informed by incident investigations, audit results, and regulatory mandates, managing policies through the formal review and approval process, including CQC review and executive ratification.

• Recognize and address ethical care considerations, provide support in decision-making for complex cases, and escalate concerns to Legal and Compliance with the necessary documentation.

• Work closely with Equip’s Data Insights & AI team to create metrics and dashboards that track clinical quality metrics, converting data into actionable insights to foster improvements and contribute to long-term strategic planning for clinical quality.

• Act as the operational lead for the CQC — organizing agendas, presenting quality data, and ensuring follow-through on committee decisions.

• Develop and continually enhance chart audit and peer review programs, analyze quality data, and translate findings into actionable insights and improvement initiatives for clinical and operational leadership.

• Provide direct oversight of the Utilization Management (UM) team, steering UM team strategy by identifying and implementing operational process enhancements and tracking KPIs to ensure consistent performance.

• Engage with external payor partners regarding utilization management processes and escalations.

• Perform additional duties as assigned.

⛳️ Requirements

• A Master’s degree or higher in a behavioral health or clinical field (e.g., MD/DO, MSW, MFT/LMFT, LPC/LP, PsyD, PhD, APRN, NP, RN with a clinical leadership focus, or equivalent).

• Independent clinical licensure relevant to your setting (e.g., MD/DO, LCSW, LMFT, LP, LPC, RN, APRN).

• 8+ years of experience in behavioral health with a proven track record in either clinical quality improvement, utilization management, or a meaningful combination of both within virtual/telehealth, managed care, integrated delivery, or provider-based environments.

• Demonstrated experience in reviewing behavioral health clinical documentation and applying medical necessity criteria that align with payer and regulatory requirements in a telehealth environment.

• In-depth knowledge of evidence-based standards applicable to behavioral health; familiarity with telemedicine adaptations of these standards and knowledge of eating disorder treatment is advantageous.

• Direct experience in designing or leading clinical quality programs in a virtual setting (e.g., chart audits, peer review, incident management, root cause analysis, policy/guideline development).

• 3+ years of progressive leadership experience, including managing multidisciplinary teams (therapists, dietitians, physicians/apps, QM, UM, auditing, or compliance staff) in a remote or telehealth context.

• Proven capability to balance the interests of patients, providers, and payors while maintaining clinical and ethical standards in a virtual care model.

• Familiarity with governance structures (e.g., Clinical Quality Committee) and remote collaboration tools.

• Proficient in telehealth platforms, EMR/eClinical systems, and digital chart review; ability to utilize data to drive quality improvement in a virtual environment.

• Awareness of HIPAA privacy requirements and the importance of safeguarding confidential information in telehealth and cloud-based settings.

• Understanding of payer policies related to virtual behavioral health, telemedicine reimbursement considerations, and utilization management workflows in remote care.

• Knowledge of regulatory and accreditation requirements affecting telebehavioral health (e.g., telemedicine compliance, state licensure compacts, and relevant telehealth guidelines) and the ability to align these with clinical practices.

• Exceptional ability to convert clinical data into actionable improvement initiatives across teletherapy, tele-dietary services, and psychiatric care, with support from clinicians and app-based care teams.

• Strong collaboration skills with Compliance, Legal, IT/Product, Revenue Cycle, and Operations in a virtual ecosystem.

• Excellent communication and interpersonal skills with internal and external stakeholders, experience in facilitating remote governance meetings, presenting quality and utilization data to executive audiences, and utilizing dashboards and data visualization tools for accountable follow-through.

🏝️ Benefits

• Flexible PTO policy (3-5 weeks/year recommended) + 11 paid company holidays.

• Generous parental leave.

• Competitive Medical, Dental, Vision, Life, and AD&D insurance.

• Equip covers a significant percentage of benefits premiums for both individuals and families.

• Spring Health, a fully employer-paid mental health benefit provided through Guardian.

• Five free therapy sessions and five free coaching sessions annually for you and each of your dependents.

• Employee Assistance Program (EAP), a company-paid resource for mental health, legal services, financial support, and more!

• HealthJoy, a 100% employer-paid platform that connects you with a healthcare concierge to help navigate your benefits.

• 401K option available!

• $50/month stipend directly added to an employee’s paycheck to cover home internet expenses.

• $250/month stipend available for use in a co-working space.

• Initial work-from-home stipend of up to $500.

• Reload of $200 on the home office stipend at the 3-year mark and every other year thereafter.

• Company-provided laptop.