Part-Time Clinical Quality Specialist

About SonderMind

SonderMind is dedicated to providing personalized and connected mental health care at every stage of life, including therapy, medication management, and mindfulness practices. The organization integrates advanced digital tools and research to enhance care quality and support thriving clinical practices. SonderMind blends technology with personal connection to improve behavioral health outcomes.

Team members are expected to proficiently use AI-driven productivity tools such as Gemini, ChatGPT, Claude, and GitHub Copilot as part of their daily work and adapt to evolving technologies.

Role Overview

The Clinical Quality Specialist position is a part-time role (up to 30 hours weekly) focused on protecting and elevating clinical care standards across the organization through utilization management, payor-facing clinical audits, and quality assurance activities. The role ensures that care meets medical necessity, is properly documented, and complies with established evidence-based and payer requirements, creating a strong foundation for provider success and compliant operations.

This position acts as a collaborative and supportive liaison between clinicians, payors, and internal quality teams, applying clinical expertise with rigorous utilization review and audit preparation.

Key Responsibilities

• Execute prospective, concurrent, and retrospective utilization reviews assessing medical necessity and treatment appropriateness.
• Utilize evidence-based criteria to evaluate documentation supporting authorization and appeals.
• Analyze care utilization trends and intensities to identify and address outliers.
• Coordinate with health plans for external utilization review requests and peer reviews.
• Investigate and resolve provider issues arising from utilization findings, client complaints, or external sources.
• Monitor adverse clinical events and collaborate with cross-functional teams to mitigate risks.
• Support initiatives aimed at enhancing measurement-based care and improving clinical outcomes.
• Collect and analyze utilization metrics and review data to guide quality improvement efforts.
• Identify systemic trends and workflow gaps, providing insights and recommendations to leadership.

Success Indicators

• Accurate, timely completion of utilization reviews meeting payer and regulatory standards.
• Translation of review findings into actionable provider improvement plans.
• Independent case management with sound clinical reasoning and thorough documentation.
• Recognition as a knowledgeable, collaborative resource across departments.
• Maintenance of constructive, trust-based provider relationships during remediation.
• Proactive identification and communication of utilization trends to leadership.

Candidate Profile

• Master’s degree in a mental health field.
• Current clinical license in good standing (e.g., LMFT, LPC, LCSW, LMHC, or equivalent).
• Experience with utilization management or clinical audits, preferably in behavioral health or health plan settings.
• Knowledge of payer requirements and level-of-care criteria.
• Strong clinical judgment with experience managing adverse events and quality investigations.
• Proven ability to produce clear, accurate, and defensible clinical documentation.
• Effective interpersonal and collaborative skills across multiple teams.
• Commitment to provider support and clinical quality assurance.
• Familiarity with clinical documentation and case tracking technologies.

Compensation and Terms

The role offers $40-$42 per hour for up to 30 hours per week. Recruitment is ongoing until the position is filled.

Equal Opportunity Statement

SonderMind provides equal employment opportunities without discrimination based on race, gender, age, disability, or any protected status under applicable laws.