Clinical Quality Manager, Medication Care

Our mission: eliminating every barrier to mental health. Spring Health is a global mental health company on a mission to eliminate every barrier to mental health. We're building a world where getting support is simple, personal, and built around the person, so care can continue through every job, move, health plan, and life stage. Spring Health's AI-native platform helps us deliver personalized support across self-guided tools, coaching, therapy, medication management, and specialty care. With outcomes independently validated by JAMA Network Open and the Validation Institute, Spring Health reaches more than 170 million people worldwide through leading employers, health plans, and partners. As an AI-native company, we believe technology should expand the reach, quality, and humanity of care. Every Spring Health team member is expected to use AI tools thoughtfully, apply human judgment to AI outputs, and keep building AI fluency in ways that support their role and our mission. The Clinical Quality Manager - Medication Care is responsible for driving and maintaining the highest standards of clinical quality for our Medication Providers. This position focuses on critical quality assurance programs, including investigating quality of care complaints, managing the annual peer review process, and leading initiatives to improve provider delivery of care and workflow efficiency. This role collaborates cross-functionally with Clinical Leadership, Legal/Compliance, Credentialing, Provider Operations, Clinical Operations, Clinical Product, and Business Intelligence teams to support scalable quality operations and systems optimization initiatives. This a full time, fully remote position on our team. Occasional travel may be required for team or company events/meetings. What You’ll Do Conduct investigations into Quality of Care (QoC) concerns by reviewing member complaints, provider documentation, and internal quality metrics to determine appropriate remediation or corrective actions in alignment with organizational policies and established quality frameworks. Exercise strong clinical judgment in determining provider interventions, escalations, and follow-up compliance monitoring, consulting with leadership for recommendations as appropriate. Partner with Medication Prescribers to obtain additional information, provide performance coaching, reinforce platform policies, procedures, and quality standards, and support ongoing quality improvement initiatives. Perform post-intervention compliance audits to evaluate provider improvement, identify persistent compliance gaps, and determine whether further escalation or corrective action is warranted. Analyze and report on quality trends, recurring performance concerns, and provider performance data to support continuous quality improvement initiatives and operational decision-making. Manage the annual peer review program for all Medication Prescribers, ensuring timely review completion, intervention tracking, provider follow-up, and compliance with organizational and regulatory standards. Maintain and optimize peer review tracking systems and documentation processes to monitor review completion, remediation activities, and quality outcomes. Partner with clinical leadership to operationalize peer review findings and facilitate provider performance improvement initiatives. Serve as a Medication Management quality subject matter expert and liaison for cross-functional initiatives involving clinical quality, provider operations, compliance, credentialing, and workflow optimization. Develop educational materials, slide decks, and supporting documentation required for Onboarding, Continuing Education,and other professional development activities for Medication Providers. Identify gaps in Medication Management policies and procedures and update/review policy manual to ensure alignment with clinical workflows, documentation standards, regulatory requirements, and organizational quality expectations. Collaborate with Legal/Compliance, Provider Operations, Clinical Operations, and other stakeholders on Quality of Care investigations, quality initiatives, operational projects, and systems development efforts. What Success Looks Like In This Role Thoroughly and efficiently investigate complaints and grievances within specified SLA’s Consistently make decisions about appropriate interventions for providers based on quality standards Deliver detailed guidance to providers to improve performance and ensure contract compliance Complete Medication Provider annual peer review on time and in accordance with process evaluation expectations. Complete project-based work on time and at high quality What You’ll Bring Behavioral Health Technician, Medical Assistant, LPN, RN, or similar direct care delivery role within the behavioral health field 3-5 years of experience in fast-paced direct healthcare, technology or clinical research environments Expertise in medical terminology, common medications, and conditions for behavioral health concerns Experience working directly with medical providers on delivering high quality care Outstanding written & verbal communication skills with collaborators and providers at all levels High level of attention to detail A thoughtful and collaborative approach to implementing continuous process improvement methodologies Ability to thrive in a fast-paced environment Humility, resourcefulness, empathy, professionalism Demonstrated passion for, and understanding of, mental health and the broader U.S. healthcare system. Global health experience is a plus. Experience working with ZenDesk, SalesForce or similar customer service platforms a plus Active LPN, RN, or NP license with a minimum of 3 years of clinical experience in behavioral health, psychiatric care, medication management, or related healthcare settings, Experience supporting provider populations prescribing psychiatric medications. Experience in behavioral health quality assurance, provider performance management, clinical operations, or healthcare quality improvement. Strong knowledge of clinical documentation standards, provider quality oversight, and behavioral healthcare compliance requirements. Strong organizational skills and attention to detail, with the ability to manage multiple concurrent workstreams and operational priorities. Experience developing, maintaining, or improving operational workflows, reporting systems, dashboards, or quality tracking tools. Strong written and verbal communication skills with the ability to engage providers and cross-functional stakeholders in a clear, professional, and constructive manner. Experience developing provider-facing educational materials, onboarding resources, operational guidance, or training documentation. Ability to thrive in a fast-paced and evolving environment with shifting priorities and operational ambiguity. Collaborative, solutions-oriented, and operationally minded approach to problem solving. Interest in leveraging AI-enabled tools, workflow automation, and systems improvements to improve quality operations and administrative efficiency. Nice To Have Providing tele-behavioral health. EAP experience a plus Managing peer review initiatives. Support for accreditation and regulatory bodies Works with ZenDesk, SalesForce or similar customer service platforms a plus Benefits are subject to individual plan requirements and eligibility criteria. Health, Dental, Vision benefits start on your first day at Spring. You and your dependents also receive access to One Medical accounts HSA and FSA plans are also available, with Spring contributing up to $1K for HSAs, depending on your plan type. Employer sponsored 401(k) match of up to 2% for retirement planning A yearly allotment of no cost visits to the Spring Health network of therapists, coaches, and medication management providers for you and your dependents. We offer competitive paid time off policies including vacation, sick leave and company holidays. At 6 months tenure with Spring, we offer parental leave of 18 weeks for birthing parents and 16 weeks for non-birthing parents. Access to Noom, a weight management program—based in psychology, that’s tailored to your unique needs and goals. Access to fertility care support through Carrot, in addition to $4,000 reimbursement for related fertility expenses. Access to Wellhub, which connects employees to the best options for fitness, mindfulness, nutrition, and sleep in one subscription Access to BrightHorizons, which provides sponsored child care, back-up care, and elder care Up to $1,000 Professional Development Reimbursement a year. $200 per year donation matching to support your favorite causes. Not sure if you meet every requirement? Research shows that women and people from historically underrepresented communities often hesitate to apply for roles unless they meet every qualification compared to other similarly-qualified candidates. At Spring Health, we are committed to fostering a workplace where everyone feels valued, empowered, and supported to Thrive. Our privacy policy: Spring Health is proud to be an equal opportunity employer. We do not discriminate in hiring or any employment decision based on race, color, religion, national origin, age, sex, marital status, ancestry, disability, genetic information, veteran status, gender identity or expression, sexual orientation, pregnancy, or other applicable legally protected characteristic. We also consider qualified applicants regardless of criminal histories, consistent with applicable legal requirements. Spring Health is also committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. If you have a disability or special need that requires accommodation, please let us know. Compensation Range: $97K - $113.5K #J-18808-Ljbffr Spring Health