Part-Time Clinical Quality Specialist

About SonderMind

SonderMind is dedicated to offering a personalized, connected, and effective mental health platform for individuals at every stage of life. Their comprehensive care spans therapy, medication management, and mindfulness practices. Leveraging digital tools and research, clinicians are empowered to provide high-quality care and grow successful practices. SonderMind integrates technology and human connection to enhance mental health outcomes.

Employees at SonderMind are expected to proficiently utilize modern AI tools in their daily work and adapt continuously to evolving technologies. Familiarity with AI platforms such as Gemini, ChatGPT, Claude, GitHub Copilot, and similar industry-leading tools is essential.

Role Overview

The Part-Time Clinical Quality Specialist is crucial in maintaining clinical care integrity focused on utilization management, payor-related clinical audits, and quality assurance. The role ensures care is necessary, properly documented, and compliant with evidence-based standards and payor requirements. It supports both provider success and clinical compliance through collaborative evaluation.

This position requires up to 30 hours weekly and is onsite in Atlanta, GA.

Key Responsibilities

• Conduct utilization reviews—prospective, concurrent, and retrospective—to verify medical necessity, suitable treatment, and care levels.
• Use evidence-based criteria for evaluation to assist authorization and appeals.
• Identify utilization trends and outliers to guide provider interventions.
• Coordinate with health plans on external utilization review requests and peer reviews.
• Address and resolve provider concerns from utilization findings and related complaints.
• Monitor clinical adverse events to apply early-stage risk mitigation with cross-functional teams.
• Contribute to initiatives aimed at improving clinical outcomes using measurement-based care.
• Track utilization data and case outcomes to support ongoing quality improvements.
• Identify process gaps and recommend policy and workflow enhancements to leadership.

Success Indicators

• Timely and accurate completion of utilization reviews in compliance with regulations.
• Use of review findings to develop actionable provider support and enhance care appropriateness.
• Independent case management with strong clinical reasoning and documentation.
• Trusted collaboration with cross-functional teams on utilization management and quality.
• Maintaining constructive relationships with providers during remediation processes.
• Proactive identification of systemic trends with leadership recommendations.

Candidate Profile

• Master’s degree in a mental health discipline.
• Current, active clinical license such as LMFT, LPC, LCSW, LMHC, or equivalent.
• Experience in utilization management, clinical auditing, or medical necessity review, preferably in behavioral health or health plan settings.
• Knowledgeable about payor mandates, medical necessity criteria, and care level guidelines.
• Strong clinical judgment including handling escalations and adverse events.
• Ability to generate clear, accurate, and defensible clinical documentation.
• Effective collaboration skills across diverse teams.
• Commitment to supporting providers and quality management processes.
• Familiarity with clinical technologies for documentation, tracking, and data analysis to improve quality and compliance.

Compensation & Additional Information

The position offers an hourly wage ranging from $40 to $42, with a weekly maximum of 30 hours.

The application process is ongoing until the role is filled.

Equal Opportunity

SonderMind values diversity and does not discriminate based on race, color, creed, sex, gender, gender identity or expression, pregnancy or related conditions, religion, veteran or military status, marital or domestic partner status, age, national or ethnic origin, disability, medical condition, sexual orientation, or any other legally protected status.