[Hiring] Clinical Quality Manager @Spring Health

Role Description

The Clinical Quality Manager - Medication Care is responsible for driving and maintaining the highest standards of clinical quality for our Medication Providers. This position focuses on critical quality assurance programs, including:

• Investigating quality of care complaints
• Managing the annual peer review process
• Leading initiatives to improve provider delivery of care and workflow efficiency

This role collaborates cross-functionally with various teams to support scalable quality operations and systems optimization initiatives. This is a full-time, fully remote position, with occasional travel required for team or company events/meetings.

What you’ll do:

• Conduct investigations into Quality of Care (QoC) concerns by reviewing member complaints, provider documentation, and internal quality metrics.
• Exercise strong clinical judgment in determining provider interventions, escalations, and follow-up compliance monitoring.
• Partner with Medication Prescribers to obtain additional information and provide performance coaching.
• Perform post-intervention compliance audits to evaluate provider improvement.
• Analyze and report on quality trends and provider performance data.
• Manage the annual peer review program for all Medication Prescribers.
• Maintain and optimize peer review tracking systems and documentation processes.
• Partner with clinical leadership to operationalize peer review findings.
• Serve as a Medication Management quality subject matter expert.
• Develop educational materials and supporting documentation for Medication Providers.
• Identify gaps in Medication Management policies and update/review policy manual.
• Collaborate with various stakeholders on Quality of Care investigations and initiatives.

What success looks like in this role:

• Thoroughly and efficiently investigate complaints and grievances within specified SLAs.
• Consistently make decisions about appropriate interventions for providers.
• Deliver detailed guidance to providers to improve performance.
• Complete Medication Provider annual peer review on time.
• Complete project-based work on time and at high quality.

Qualifications

• Behavioral Health Technician, Medical Assistant, LPN, RN, or similar direct care delivery role.
• 3-5 years of experience in fast-paced direct healthcare, technology, or clinical research environments.
• Expertise in medical terminology, common medications, and conditions for behavioral health concerns.
• Experience working directly with medical providers on delivering high-quality care.
• Outstanding written & verbal communication skills.
• High level of attention to detail.
• A thoughtful and collaborative approach to implementing continuous process improvement methodologies.
• Ability to thrive in a fast-paced environment.
• Humility, resourcefulness, empathy, professionalism.
• Demonstrated passion for, and understanding of, mental health and the broader U.S. healthcare system.
• Active LPN, RN, or NP license with a minimum of 3 years of clinical experience.
• Experience supporting provider populations prescribing psychiatric medications.
• Experience in behavioral health quality assurance, provider performance management, clinical operations, or healthcare quality improvement.
• Strong knowledge of clinical documentation standards and provider quality oversight.
• Strong organizational skills and attention to detail.
• Experience developing, maintaining, or improving operational workflows.
• Experience developing provider-facing educational materials.
• Collaborative, solutions-oriented, and operationally minded approach to problem solving.

Requirements

• Experience working with ZenDesk, SalesForce, or similar customer service platforms is a plus.

Benefits

• Health, Dental, Vision benefits start on your first day.
• Employer sponsored 401(k) match of up to 2% for retirement planning.
• A yearly allotment of no-cost visits to the Spring Health network of therapists.
• Competitive paid time off policies 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 tenure.
• Access to Noom, a weight management program.
• Access to fertility care support through Carrot.
• Access to Wellhub for fitness, mindfulness, nutrition, and sleep.
• Access to BrightHorizons for sponsored child care and elder care.
• Up to $1,000 Professional Development Reimbursement a year.
• $200 per year donation matching to support your favorite causes.