Clinical Quality Specialist

Clinical Quality Specialist ABOUT SONDERMIND At SonderMind, we believe everyone deserves one personalized, connected, and effective mental health destination to take care of their mental health and well-being at any stage of life. SonderMind care encompasses everything from therapy and medication management to meditation and mindfulness exercises. Our clinicians leverage our digital tools and research to deliver increasingly high-quality care and to develop thriving practices. Combining technology and human connection, SonderMind drives better outcomes through our comprehensive approach. Learn more about SonderMind at sondermind.com or download the mobile app, available on iOS and Android. To follow the latest SonderMind news, get to know our clients, and learn about what it’s like to work at SonderMind, you can follow us on Instagram https://www.instagram.com/sondermind/?hl=en, Linkedin https://www.linkedin.com/company/sondermind/, and Twitter https://twitter.com/SonderMind?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor. Additionally, we expect all team members to effectively leverage modern AI technologies as part of their everyday workflow, and to continuously adapt as new tools emerge. Familiarity with job-relevant AI platforms such as Gemini, ChatGPT, Claude, GitHub Copilot or other industry-standard AI productivity tools is expected and considered essential for success at this company. ABOUT THE ROLE The Clinical Quality Specialist role exists to uphold and strengthen the quality of care within the organization. This position ensures that clients and clinicians are supported with the right resources, processes, and interventions to deliver excellent, evidence-based care. The role is designed to be collaborative and supportive, focusing on provider success and client outcomes. WHAT YOU’LL DO - Work with Customer Support, Product, Provider Success, Clinical Quality, and Care Coordination teams to execute end-to-end clinical roadmaps and SOPs highlighting priorities, KPIs, cross-functional ownership, and workflows. - Provide ongoing support to providers to help them maintain high quality care delivery and professional growth. - Engage in provider investigation, remediation, and termination processes stemming from client-reported complaints, health plans, or other external reports. - Monitor, track, and respond to clinical adverse events. - Assist with identification, monitoring, and interfacing with outliers in the provider group. - Conduct clinical utilization reviews (CURs) to assess care quality and inform provider support. - Work under the leadership of the Clinical Quality Manager to ensure evidence-based practices (including measurement-based care) are utilized effectively. - Contribute to clinical research development related to delivering high quality clinical outcomes. - Assess and implement proactive interventions through trends in provider complaints. - Proactively identify and apply early-stage risk mitigation strategies, collaborating with cross-functional partners to address potential clinical or operational issues before escalation. - Support billing-related investigations by gathering documentation and escalating concerns to leadership. - Surface trends and potential gaps in clinical processes to leadership for review. - Identify creative ways to incentivize and support the provider network and collaborate with clinical education to develop training opportunities. WHAT DOES SUCCESS LOOK LIKE? - Consistently build trust and rapport with providers by offering timely, supportive, and solution-oriented guidance. - Exercise sound clinical judgment when processing escalations, adverse events, and provider outliers, independently completing thorough documentation and collaborating with the Clinical Quality Manager to determine appropriate next steps. - Meet monthly company case targets while ensuring accuracy and timely processing. - Independently process and manage cases with minima ... (truncated, view full listing at source)