Senior Clinical Quality Manager, AI Transformation

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

📋 Description

• Oversee intricate cross-functional initiatives from strategy to execution utilizing AI-centric technology solutions, enhancing automations and intelligent decision support.

• Convert provider policies, standard operating procedures, playbooks, and clinical resources into dynamic, interactive tools designed to enhance provider care quality and effectiveness while ensuring compliance with all legal, regulatory, and payer standards.

• Create innovative performance feedback tools for providers to highlight strengths, tackle risks and areas needing improvement, provide targeted education, and facilitate continuous professional development, equipping them with resources and actionable steps to reach their objectives.

• Develop scalable operational workflows for quality teams that boost efficiency, minimize manual tasks, and enhance provider experiences.

• Propel systems integrations across enterprise tools to reinforce the monitoring of quality improvement initiatives that influence care delivery outcomes and uncover strategic opportunities for ongoing enhancement.

• Aid in establishing reporting standards for compliance and quality of care, including formulating review criteria and suggesting new process innovations to better assess success.

• Formulate and uphold policies that ensure compliance with accreditation and regulatory requirements (e.g., CARF, NCQA).

• Act as a strategic leader in initiatives aimed at preventing Fraud, Waste, and Abuse (FWA).

• Lead and/or engage in additional projects as assigned.

⛳️ Requirements

• LMFT, LCSW, LPC, or Licensed Psychologist with a minimum of 7+ years of post-licensure experience, including tele-behavioral health expertise. Experience in Employee Assistance Programs (EAP) is a plus.

• At least 4 years of experience leading functions in clinical quality, clinical operations, provider operations, healthcare operations, or strategic program management.

• Comprehensive understanding of clinical best practices, healthcare quality, provider operations, legal and regulatory requirements, and accreditation standards for clinical care delivery.

• Proven experience in creating performance management frameworks, policies, SOPs, training programs, and operational documentation.

• A systems-thinking mindset with expertise in designing scalable operational processes.

• Demonstrated ability to lead cross-functional strategic initiatives from concept through execution, adopting a collaborative approach with meticulous attention to detail.

• Outstanding written and verbal communication skills, along with stakeholder management abilities, capable of influencing at all levels of the organization.

• Strong analytical skills with a track record of translating complex operational data into strategic decisions.

• Proven fluency in AI, including the capability to effectively leverage generative AI and intelligent automation to enhance workflows, speed execution, and improve decision-making.

• Established ability to identify opportunities for process redesign using an AI-first approach while ensuring adherence to governance, privacy, and quality standards.

• Comfortable assessing emerging AI capabilities and incorporating them into operational and quality strategies.

• Ability to excel in a fast-paced environment with humility, empathy, professionalism, a desire to learn, and the adaptability to thrive amid change.

🏝️ Benefits

• Health, Dental, and Vision benefits commence on your first day at Spring. You and your dependents will also have access to One Medical accounts. HSA and FSA plans are available, with Spring contributing up to $1K for HSAs, depending on your plan type.

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

• A yearly allotment of complimentary visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents.

• We provide competitive paid time off policies, including vacation, sick leave, and company holidays.

• After 6 months with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents.

• Access to Noom, a psychology-based weight management program tailored to your individual needs and goals.

• Access to fertility care support via Carrot, along with a $4,000 reimbursement for related fertility expenses.

• Access to Wellhub, connecting employees to premier options for fitness, mindfulness, nutrition, and sleep in a single subscription.

• Access to BrightHorizons, offering sponsored child care, backup care, and elder care services.

• Up to $1,000 Professional Development Reimbursement annually.

• $200 per year in donation matching to support your chosen causes.