Part-Time Clinical Quality Specialist

Company Overview

SonderMind is committed to providing a personalized and connected mental health experience, catering to individuals at any life stage. Their services extend from therapy and medication management to mindfulness practices, combining human connection with technology to enhance mental health outcomes.

Role Overview

The Part-Time Clinical Quality Specialist plays a vital role in ensuring the clinical excellence and regulatory compliance of mental health care delivered within the organization. Focusing on utilization management, clinical audits, and quality assurance, the position supports providers and maintains high standards aligned with payor requirements.

Key Responsibilities

• Conduct various utilization reviews to verify medical necessity and treatment appropriateness.
• Apply evidence-based criteria to clinical documentation, supporting authorization and appeals.
• Observe care intensity and utilization trends to identify anomalies for targeted provider intervention.
• Collaborate with health plans on external utilization review requests and peer reviews.
• Address provider concerns arising from utilization management outcomes, complaints, or external sources.
• Monitor adverse clinical events and coordinate risk mitigation with cross-functional teams.
• Support initiatives focused on measurement-based care to enhance clinical outcomes.
• Track utilization metrics and case results to guide continuous quality improvements.
• Identify patterns and procedural gaps, providing recommendations to leadership for refining policies.

Success Indicators

• Completion of utilization reviews that are precise, timely, and compliant.
• Implementation of provider support plans leading to improved care appropriateness.
• Independent case management with thorough documentation and strong clinical reasoning.
• Establishing trustful and effective collaboration with cross-functional partners and providers.
• Proactive identification of systemic trends and suggestions for organizational enhancements.

Candidate Profile

• Master’s degree in a mental health discipline.
• Possession of an active, valid clinical license (e.g., LMFT, LPC, LCSW, LMHC).
• Experience with utilization management, review, or clinical auditing especially in behavioral health or payor contexts.
• Knowledgeable in payor guidelines, medical necessity standards, and level of care protocols.
• Strong clinical judgment and experience managing escalations or quality investigations.
• Proven capacity to generate clear, accurate clinical documentation.
• Ability to collaborate effectively across multiple teams and departments.
• Commitment toward supporting providers and ensuring clinical quality.
• Comfort with clinical technologies used for documentation, case tracking, and data analytics.

Compensation and Work Details

This part-time role offers an hourly wage ranging from 40 to 42 dollars, with a maximum of 30 working hours per week.

Hiring Process

The recruitment for this position will continue until the vacancy is filled.

Equal Opportunity Statement

SonderMind upholds equal employment opportunities without regard to race, color, creed, sex, gender identity or expression, pregnancy, religion, veteran status, marital status, age, disability, sexual orientation, or any legally protected category under federal, state, or local laws.

Technology Integration

Team members are expected to effectively utilize artificial intelligence tools such as Gemini, ChatGPT, Claude, or GitHub Copilot as part of their daily workflow and adapt to new AI technologies as they arise.