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Reporting to the Senior Director of Clinical Quality and Safety on the Medical Affairs team, the Clinical Quality Manager will be responsible for investigating care quality and care service escalations as well offering outstanding guidance and consultation as part of our performance improvement efforts for providers. You’ll work closely with our providers, care support teams, care operations teams, and our quality team to improve care delivery at Spring Health. This is a full time remote position on our team and may require occasional travel for company or team events.
Job Responsibility:
Investigate and resolve care complaints and grievances about providers
Partner with quality team members to evolve detailed guidance around provider performance management, including amplifying strengths, addressing risks, further developing skills, and creating actions plans to achieve these outcomes
Provide training, coaching, and technical assistance to providers, as needed
Develop and monitor Quality Improvement initiatives and activities that drive care delivery outcomes
Monitor program activities across the population of care providers to ensure adherence to clinical best practice standards, Spring Health policies and procedures, and contract compliance
Assist in maintaining Spring Health Provider Policy Guide to maintain compliance with all legal, regulatory, and payer requirements
Assist in developing reporting standards for compliance and quality of care, including establishing review criteria and recommending new innovations in processes to better evaluate success
Review and interpret data, as necessary, to assist in identifying trends
Lead and/or participate in additional projects as assigned
Embrace flexibility for continuous innovation and adaptability when priorities shift based on business needs
Requirements:
LMFT, LCSW, LPC, or Licensed Psychologist with minimum 3 years post licensure experience
Experience providing tele-behavioral health. EAP experience a plus
2 years clinical management or supervisory experience preferred
Strong working knowledge of the legal and ethical aspects of clinical care delivery
Comfort and excitement with queue-based support execution
Outstanding written and verbal communication skills with teammates and providers at all levels
Ability to thrive in a fast-paced workplace, including eagerness to learn and adapt to a changing environment
High level of attention to detail
A thoughtful and collaborative approach to problem solving and clinical collaboration
Demonstrated passion for, and understanding of, mental health and the broader U.S. healthcare system
Experience working with ZenDesk, SalesForce or similar customer service platforms a plus
Nice to have:
EAP experience a plus
Experience working with ZenDesk, SalesForce or similar customer service platforms a plus
What we offer:
Health, Dental, Vision benefits start on your first day
HSA and FSA plans are also available, with Spring contributing up to $1K for HSAs
Employer sponsored 401(k) match of up to 2%
A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents
Competitive paid time off policies including vacation, sick leave and company holidays
At 6 months tenure with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents
Access to Noom, a weight management program
Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses
Access to Wellhub, which connects employees to the best options for fitness, mindfulness, nutrition, and sleep in one subscription
Access to BrightHorizons, which provides sponsored child care, back-up care, and elder care
Up to $1,000 Professional Development Reimbursement a year
$200 per year donation matching to support your favorite causes