[Hiring] Associate Clinical Director, Integrated Care Quality (NP/MD) @Included Health

Role Description

The Associate Clinical Director, Integrated Care Quality (NP/MD) is responsible for the strategy, external representation, and program leadership needed to ensure our clinical services perform credibly in high-stakes client, consultant, and audit-facing settings.

This role leads the clinical quality approach to client audits, consultant engagement, and longitudinal quality assurance across relevant services. The Director will:

• Represent Included Health in consequential meetings with clients, consultants, health plans, and internal leaders.
• Shape the vision for external-facing clinical quality work.
• Build trusted relationships.
• Translate audit and quality findings into durable operational improvement strategies.

Establishing a robust longitudinal oversight process is a primary objective for this position. This leader will:

• Drive the development of systems to monitor member journeys, ensure care quality, and maintain service reliability over time.
• Utilize AI-driven quality surveillance and pattern detection to modernize and scale quality operations.

Responsibilities

• Client and Consultant Leadership
  • Represent Included Health clinical services in high-stakes client, consultant, and audit-related discussions.
  • Build strong relationships with clients, consultants, health plans, and internal commercial partners.
  • Serve as a trusted clinical quality voice in escalations, performance reviews, corrective action discussions, and executive forums.
  • Translate complex clinical and operational issues into clear, credible, executive-ready narratives.
• Client Audit Strategy and Execution
  • Own the strategy and operating model for clinical client audit readiness.
  • Lead audit planning, preparation, risk triage, file review standards, and executive readiness.
  • Serve as the senior clinical lead for audit content, responses, and remediation planning.
  • Ensure audit findings are converted into measurable action plans with clear ownership and follow-through.
• Longitudinal Quality Assurance
  • Lead the design and maturation of longitudinal QA models that assess quality across the member journey.
  • Build proactive oversight frameworks that identify risks before they surface in audits, escalations, or client dissatisfaction.
  • Connect quality findings across service lines to identify systemic issues, not isolated defects.
  • Ensure longitudinal QA informs coaching, workflow redesign, policy refinement, and client readiness.
• AI-Enabled Quality at Scale
  • Lead the use of AI and advanced analytics to scale quality surveillance, longitudinal review, and audit readiness.
  • Define where AI can responsibly augment human review, including trend detection, review prioritization, and documentation assessment.
  • Partner with product, engineering, analytics, and AI quality leaders to build safe, clinically credible workflows.
  • Ensure AI-supported quality programs maintain strong human oversight, validation, and calibration.
• Population Health Quality Oversight and Performance Management
  • Own population health quality oversight across relevant clinical programs, with accountability for defining, monitoring, and improving program performance.
  • Establish and govern a metric framework spanning clinical quality, operational performance, service reliability, and member outcomes.
  • Define metric ownership, thresholds, escalation triggers, and review cadences in partnership with clinical, operational, analytics, and client-facing leaders.
  • Translate performance findings into concrete action, including corrective plans, workflow redesign, policy refinement, and program accountability.
  • Build scalable oversight processes that connect longitudinal QA, audit findings, escalations, and program data into a unified view of quality across the member journey.

Qualifications

• Required:
  • Physician or Nurse Practitioner with current unrestricted U.S. license in good standing.
  • Board certification required for physicians.
  • 7+ years of clinical, healthcare quality, patient safety, or clinical operations experience with progressive responsibility.
  • 3+ years of experience leading or materially shaping client-facing quality work, external audits, consultant engagement, or similar high-stakes external clinical work.
  • Demonstrated experience representing clinical services in consequential syncs with clients, consultants, auditors, health plans, or senior executives.
  • Strong experience in quality strategy, audit readiness, program development, and cross-functional leadership.
  • Excellent written and verbal communication skills, with the ability to tailor messaging to clinicians, clients, consultants, and executives.
  • Strong analytical and systems-thinking skills, with comfort interpreting quality and operational data.
  • Proven ability to build relationships, influence without authority, and lead through ambiguity.
• Preferred:
  • Experience in population health, care navigation, care management, virtual care, or other longitudinal care models.
  • Experience designing or leading longitudinal QA or proactive surveillance models.
  • Experience leveraging agentic AI or advanced analytics to scale quality oversight.
  • Familiarity with external quality or accreditation frameworks such as URAC, NCQA, HEDIS, or MIPS.
  • Experience with tools such as Looker, Tableau, Observe.AI, or advanced spreadsheet analysis.
  • CPHQ, CPPS, Lean Six Sigma, or similar training/certification.

Benefits

• Remote-first culture
• 401(k) savings plan through Fidelity
• Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)
• Paid Time Off ("PTO") and Discretionary Time Off ("DTO")
• 12 weeks of 100% Paid Parental leave
• Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies.
• Work-From-Home reimbursement to support team collaboration home office work