Part-Time Clinical Quality Specialist

About SonderMind

SonderMind is committed to providing a unique and integrated mental health experience, delivering therapy, medication management, and mindfulness practices to improve wellbeing at any life stage. Our platform combines technology and personal interaction to enhance clinical outcomes and support thriving practices.

We encourage all team members to integrate modern AI tools—including Gemini, ChatGPT, Claude, and GitHub Copilot—into their daily workflow to maintain excellence in care and adapt to emerging productivity technologies.

Role Overview

The Clinical Quality Specialist works part-time (up to 30 hours weekly) to protect and improve the quality of clinical services, focusing on utilization management, payor-related clinical audits, and maintaining adherence to clinical standards and documentation practices. This role acts as a liaison among clinical care teams, payors, and internal quality frameworks, ensuring that care delivery is both effective and compliant.

Key Responsibilities

• Perform prospective, concurrent, and retrospective reviews to determine medical necessity and appropriate treatment levels.
• Apply evidence-based utilization management criteria to clinical documentation, supporting authorization and appeals processes.
• Analyze care utilization data to detect trends and outliers, facilitating targeted interventions.
• Collaborate with health plans on external utilization review requests and peer-to-peer review processes.
• Address and resolve provider concerns arising from utilization management findings, client complaints, or other reports.
• Monitor and mitigate early-stage risks by partnering with multidisciplinary teams when adverse clinical events occur.
• Support initiatives focused on measurement-based care to enhance clinical outcomes across providers.
• Maintain detailed tracking of utilization metrics and case results to drive continuous quality improvements.
• Identify trends and gaps in utilization processes, providing recommendations to leadership for policy and workflow enhancements.

Success Indicators

• Accurate and timely completion of utilization reviews in line with payor and regulatory standards.
• Implementation of actionable plans following utilization review outcomes that lead to improved care quality.
• Autonomous case management demonstrating strong clinical judgment and thorough documentation.
• Recognition by cross-functional teams as a reliable and solution-driven collaborator.
• Preservation of constructive, trust-based relationships with providers, including through remediation processes.
• Proactive identification and communication of systemic utilization trends to leadership.

Qualifications

• Master's degree in a mental health discipline.
• Current, active clinical license in good standing (e.g., LMFT, LPC, LCSW, LMHC, or equivalent).
• Experience in utilization management, utilization review, medical necessity assessments, or clinical auditing, preferably within behavioral health or payor settings.
• Knowledge of payor requirements, medical necessity criteria, and level-of-care guidelines.
• Strong clinical judgment with experience managing escalations, adverse events, and quality investigations.
• Proven ability to generate clear, accurate, and defensible clinical documentation.
• Skill in collaborating across multiple teams effectively.
• Dedication to provider support and quality assurance.
• Experience using clinical technology platforms for documentation, case tracking, and data analytics to uphold provider compliance and quality.

Compensation

This position is compensated on an hourly basis between $40 and $42, for up to 30 hours weekly.

Equal Opportunity Statement

The employer values diversity and ensures equal employment opportunity without discrimination on grounds including race, color, creed, sex, gender identity or expression, pregnancy, religion, veteran status, marital status, age, national origin, disability, sexual orientation, or any legally protected status.