Part-Time Clinical Quality & Utilization Specialist

SonderMind; Seattle (WA); On-site; USD 55,104 - 57,859; Part time

Job summary

SonderMind is seeking a Part-Time Clinical Quality Specialist to safeguard and strengthen our clinical care across the organization. This role focuses on utilization management, payor-facing audits, and quality assurance, ensuring medical necessity and evidence-based practice across the provider network.

You will work collaboratively with clinicians, payors, and internal teams to review documentation, support authorization decisions, and drive continuous improvement in care quality.

Qualifications

• Experience in utilization management, utilization review, medical necessity review, or clinical auditing.
• Familiarity with payor requirements and level-of-care guidelines.
• Strong clinical judgment and ability to handle escalations and investigations.
• Clear, accurate, defensible clinical documentation.

Responsibilities

• Conduct prospective, concurrent, and retrospective utilization reviews to assess medical necessity and level of care.
• Apply evidence-based UM criteria to support authorization and appeals processes.
• Monitor utilization trends and inform provider interventions.
• Collaborate with health plans on external UR requests and peer-to-peer reviews.
• Investigate provider concerns and remediate issues arising from UM findings.
• Support measurement-based care initiatives and strengthen clinical outcomes.
• Track metrics and surface trends to leadership for continuous improvement.

Skills

Utilization management

Clinical auditing

Clinical documentation

Cross-team collaboration

Education

Master’s degree in a mental health discipline

Job description

SonderMind is seeking a Part-Time Clinical Quality Specialist to safeguard and strengthen our clinical care across the organization. This role focuses on utilization management, payor-facing audits, and quality assurance, ensuring medical necessity and evidence-based practice across the provider network.

You will work collaboratively with clinicians, payors, and internal teams to review documentation, support authorization decisions, and drive continuous improvement in care quality.