Director, Quality and Clinical Operations

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

📋 Description

• Oversee the daily operations of the Service Delivery & Network Teams, including project coordination, priority management, and professional development.

• Conduct analysis and scenario planning for both service delivery teams and the consultant network.

• Enhance staffing ratios, network capabilities, technology automation, efficiency, and consultant utilization.

• Track service delivery KPIs, such as response times, client satisfaction scores, and resolution rates.

• Recruit, evaluate, contract, and onboard counselors and consultants.

• Address provider issues and implement necessary operational changes.

• Report trends, opportunities, and areas for improvement within the provider network to leadership.

• Manage the budget for the designated area, including resource allocation, cost containment, and financial objectives.

• Design and refine the Quality Management program for service delivery.

• Conduct clinical and network consultant audits, case reviews, risk assessments, and compliance activities.

• Develop quality metrics and scorecards for the provider network.

• Oversee remediation and corrective action plans for providers.

• Establish quality calibration processes for frontline clinical and network consultant teams.

• Prepare for and lead accreditation surveys and regulatory audits.

• Analyze quality and compliance data, implementing process improvements and training initiatives.

• Maintain clinical policies, procedures, and quality standards.

• Report quality outcomes, risk trends, and program performance to the VP of Solutions and Clinical Operations.

• Ensure proper incident reporting and follow-up for critical incidents, complaints, and adverse events.

• Collaborate with service delivery, network providers, technology, innovation, clinical, client success, marketing, IT, and other teams.

• Lead, mentor, and develop teams in service delivery, clinical, and network management.

• Streamline service delivery processes to enhance the client experience.

• Create strategies for client experience, user journeys, proactive issue resolution, and improvements in user experience.

⛳️ Requirements

• Strong operational and strategic planning skills, with a background in provider networks.

• Proficient in case management, CRM, survey, and data management/analytics systems.

• Knowledge of HIPAA and other regulatory standards.

• Experience in developing and monitoring quality assurance processes.

• Exceptional written and verbal communication skills, including reporting to senior leadership.

• Strong relationship-building, negotiation, and cross-functional collaboration abilities.

• Proven leadership experience in influencing across organizational levels and constructing high-performing teams.

• Experience in coaching, providing feedback, planning growth, managing accountability, and recognizing team members.

• Client-focused, innovative, adaptable, technically skilled, and proactive.

• Bachelor’s degree in business administration, healthcare management, or a related field.

• Master’s degree is preferred.

• A minimum of 7–10 years of experience in service delivery or operations management, ideally in EAP, behavioral health, or healthcare sectors.

• Proven track record in managing and developing teams, including cross-functional teams.

• Experience in provider network development, consultant relations, and network management.

• Knowledgeable in change management and continuous improvement processes.

• Familiarity with process design and implementation.

• Experience managing user satisfaction, NPS, and voice-of-the-client programs.

• Demonstrated experience in root cause analysis.

• Familiarity with project management, Lean, agile, and other development methodologies.

• Ability to perform essential duties and responsibilities, with reasonable accommodations available.

🏝️ Benefits

• Fully remote and flexible working arrangements.

• Comprehensive medical, dental, vision, FSA/HSA, life, and disability insurance coverage.

• Generous paid time off, including holidays and well-being days.

• Paid parental leave.

• Employer-sponsored 401(k) with a match of up to 4%, fully vested from your first day of eligibility.

• Confidential Employee Assistance Program available for employees and their family members.

• Access to a virtual assistant through our Concierge program.

• Opportunities for professional development.

• Charitable matching program.

• 8 hours of paid volunteer time granted annually.