Senior Clinical Quality Manager, AI Transformation

Rainfall Ventures; United States; Remote; USD 122,000 - 140,000; Full time

Benefits offered by this job

Health and wellness benefits

401(k) match

Job summary

Spring Health seeks a Senior Clinical Quality Manager - AI Transformation to lead cross-functional quality programs across its provider network. You will translate complex clinical and regulatory requirements into scalable, AI-enabled solutions, partnering with Clinical Leadership, Provider Operations, Product, and Compliance teams.

The role drives automation, quality improvement, and decision support while ensuring care standards align with CARF, NCQA, and regulatory expectations.

Qualifications

• Licensed clinical credential with 7+ years post-licensure.
• Experience in tele-behavioral health and EAP is a plus.
• Ability to translate clinical quality concepts into scalable programs.

Responsibilities

• Lead AI-first quality initiatives across provider network.
• Transform policies and resources into interactive tools to improve care quality.
• Design scalable workflows and drive cross-functional collaboration.
• Develop reporting standards and compliance with accreditation standards.

Skills

Cross-functional leadership

Strategic thinking

Stakeholder management

Analytical decision-making

Education

LMFT/LCSW/LPC or Licensed Psychologist (7+ years)

Job description

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.

Our 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.

Reporting to the Senior Director of Clinical Quality and Safety on the Medical Affairs team, the Senior Clinical Quality Manager - AI Transformation is responsible for leading strategic quality initiatives that strengthen provider performance, clinical quality, and operational excellence across Spring Health's provider network. This role partners cross-functionally with Clinical Leadership, Provider Operations, Product, Business Intelligence, Credentialing, Legal and Compliance, and other teams to design scalable quality programs, optimize workflows, develop provider enablement resources, and drive continuous improvement across quality systems. This role combines clinical expertise, operational leadership, and systems thinking to improve how quality is measured, managed, and scaled. The ideal candidate is an innovative, highly collaborative leader who excels at translating complex operational challenges into sustainable solutions and embraces an AI-first mindset to improve efficiency, streamline workflows, and enhance decision-making across the Quality organization.

What you’ll do:

• Lead complex cross-functional initiatives from strategy through implementation using AI-first technology solutions, optimizing automations and intelligent decision support:
• Transform provider policies, SOPs, playbooks, and clinical resources into engaging, interactive tools aimed to improve provider care quality and effectiveness and help them maintain compliance with all legal, regulatory, and payer requirements
• Innovate provider performance feedback tools to amplify provider strengths, address risks and areas for improvement, offer focused education and ongoing professional development to hone their skills, and equip them with resources and actionable steps to achieve these goals
• Design scalable quality team operational workflows that improve efficiency, reduce manual work, and enhance provider experiences.
• Drive systems integrations across enterprise tools to strengthen monitoring of quality improvement initiatives that drive care delivery outcomes and identify strategic opportunities for continuous improvement
• Assist in developing reporting standards for compliance and quality of care, including establishing review criteria and recommending new innovations in processes to better evaluate success
• Develop and maintain policies that support compliance with accreditation and regulatory standards (e.g., CARF, NCQA).
• Serve as a strategic leader in Fraud, Waste, and Abuse (FWA) prevention initiatives.
• Lead and/or participate in additional projects as assigned.

What success looks like in this role:

• Deliver strategic initiatives on time and at high quality.
• Improve provider engagement and performance through measurable increases in care delivery quality metrics.
• Reduce operational inefficiencies through process redesign, automation, and AI-enabled solutions.
• Increase adoption of scalable quality systems and standardized workflows.
• Successfully maintain regulatory readiness and accreditation compliance.
• Foster a culture of continuous improvement, innovation, and operational excellence, mentoring colleagues along the way.
• Embrace flexibility for continuous innovation and adaptability when priorities shift based on business needs

What you’ll bring:

• LMFT, LCSW, LPC, or Licensed Psychologist with minimum 7+ years post licensure experience, including experience providing tele-behavioral health. EAP experience a plus
• 4+ years experience leading functions in clinical quality, clinical operations, provider operations, healthcare operations, or strategic program management.
• Strong knowledge of clinical best practices, healthcare quality, provider operations, legal and regulatory requirements, and accreditation standards for clinical care deliver.
• Experience building performance management frameworks, policies, SOPs, training programs, and operational documentation.
• Systems-thinking mindset with experience designing scalable operational processes.
• Demonstrated experience leading cross-functional strategic initiatives from concept through implementation, with a thoughtful, collaborative approach and a high level of attention to detail.
• Exceptional written and verbal communication and stakeholder management skills, with the ability to influence across all organizational levels.
• Strong analytical skills with experience translating complex operational data into strategic decisions.
• Demonstrated AI fluency, including the ability to effectively leverage generative AI and intelligent automation to improve workflows, accelerate execution, and enhance decision-making.
• Proven ability to identify opportunities to redesign processes using an AI-first mindset while maintaining appropriate governance, privacy, and quality standards.
• Comfortable evaluating emerging AI capabilities and integrating them into operational and quality strategies.
• Ability to thrive in a fast-paced workplace with humility, empathy, professionalism, an eagerness to learn, and resourcefulness to adapt to a changing environment

Nice to Have:

• Experience partnering with Product, Data, or Engineering teams to implement technology-enabled solutions
• Demonstrated passion for, and understanding of, mental health and the broader U.S. and global healthcare system
• Experience working with enterprise workflow platforms (e.g., ZenDesk, SalesForce)
• Familiarity with healthcare accreditation standards (NCQA, CARF, Knox-Keene).

The target base salary range for this position is $121,500 - $140,000 and is part of a competitive total rewards package including equity and benefits. Individual pay may vary from the target range and is determined by a number of factors including experience, location, internal pay equity, and other relevant business considerations. We review all employee pay and compensation programs annually using Radford Global Compensation Database at minimum to ensure competitive and fair pay.

Benefits provided by Spring Health:

Note: We have even more benefits than listed here and below, your recruiter will provide more in-depth information as you continue in the interview process. 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 Medicalaccounts 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 Carrot, in addition to $4,000 reimbursement for related fertility expenses.
• Access toWellhub, 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.

Our privacy policy: https://springhealth.com/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.