Senior Director, Clinical Quality

Guidelight Health; Worcester (MA); Remote; USD 100,000 - 150,000; Full time

Job summary

Guidelight Health seeks a Senior Director of Clinical Quality responsible for upholding standards and ensuring compliance with mental health regulations. This role involves policy development, regulatory compliance monitoring, and collaboration with various teams to enhance service quality in a dynamic healthcare environment.

Qualifications

• 3+ years of leadership in compliance and/or quality assurance.
• 6+ years of hands-on operations experience in healthcare.
• Familiarity with CMS programs and NCQA accreditation experience.

Responsibilities

• Develop and implement policies to ensure compliance with regulations.
• Conduct audits to maintain compliance with mental health standards.
• Provide training on compliance issues to staff.

Skills

Leadership

Compliance

Interpersonal Skills

Organizational Skills

Time Management

Communication

Education

Master's degree in counseling, Social Work or related program

Tools

Microsoft Office

Video Conferencing Technologies

Job description

Guidelight Health is a cutting-edge behavioral healthcare company dedicated to transforming lives through high-quality PHP (Partial Hospitalization Program) and IOP (Intensive Outpatient Program) services. As a newly launched organization, we are on a mission to redefine the behavioral health industry by delivering exceptional care, utilizing state-of-the-art facilities, and prioritizing the well-being of those we serve. At Guidelight Health, we are building a team of passionate, forward-thinking professionals who are eager to be part of this exciting journey to reshape mental health care. Join us in making a lasting impact!

Description :

Title : Senior Director, Clinical Quality

Reports to : Chief Medical Officer

Department / Location : Remote

FLSA Status : Exempt

Travel Requirement : Minimal

Guidelight Health provides insurance-based intermediate levels of care that are structured, transformative, personalized, and accessible. Guidelight is an Equal Opportunity Employer. We are passionate about fostering an environment where everyone, irrespective of their race, gender, sexual orientation, or background, feels valued and included.

Summary :

The Senior Director of Clinical Quality will report to the Chief Medical Officer and be responsible for upholding ethical standards while ensuring Guidelight delivers high-quality mental health services in compliance with all applicable regulations. Specifically, this individual will ensure compliance with national and state clinical licensure regulations, payer regulations, and accrediting body regulations, particularly those set by CARF. This role demands exceptional attention to detail, seamless collaboration across our clinical, operations, payer, and growth verticals, and a strong commitment to our mission and values.

Responsibilities :

• Policy Development and Implementation

Develop, review, and update Guidelight policies and procedures to ensure compliance with federal, state, and local regulations, for both clinical and payer requirements.

• Regulatory Compliance Monitoring

Monitor changes in mental health legislation and regulations, assessing their impact on organizational practices.

• Conduct regular audits and assessments to ensure compliance with mental health standards and regulations.
• Training and Education

Design and deliver training programs for staff on mental health compliance issues, policies, and best practices.

• Promote awareness of mental health issues and compliance requirements across the organization.

Identify and assess potential compliance risks related to mental health services and develop strategies to mitigate those risks.

• Conduct incident investigations and report findings to appropriate stakeholders.
• Documentation and Reporting

Ensure accurate documentation of compliance activities, including audits, training, and incident reports.

• Prepare and submit required reports to regulatory agencies and internal stakeholders.
• Collaboration and Communication

Collaborate with legal, HR, and clinical teams to ensure comprehensive compliance across all departments.

• Act as a liaison between the organization and external regulatory bodies.
• Quality Improvement

Participate in quality improvement initiatives related to mental health services.

• Analyze compliance data to identify trends and areas for improvement.
• Client Advocacy

Ensure that client rights are protected and that services are delivered in a culturally competent manner.

• Address client complaints and concerns related to mental health services.
• Research and Development

Stay informed about emerging trends, research, and best practices in mental health compliance.

• Contribute to the development of new programs and initiatives that enhance compliance and service delivery.
• Crisis Management

Develop and implement crisis management protocols related to mental health issues within the organization.

• Provide support during critical incidents involving mental health compliance matters.

Required Qualifications :

• 3+ years of leadership in compliance and / or quality assurance.
• 6+ years of hands-on operations experience in a high-growth healthcare environment.
• Familiarity with CMS programs and NCQA accreditation survey experience, including submission of documents to accreditation agency.
• Proficiency with Microsoft Office and video conferencing technologies.
• Strong interpersonal, organizational, evaluative and time management skills.
• Excellent communication, interpersonal, and leadership skills, with the ability to build rapport and influence stakeholders at all levels.
• Passion for mental health advocacy and a commitment to fostering a supportive and inclusive workplace culture.
• Proven ability to thrive in a fast-paced, high-growth environment.

Preferred Qualifications :

• Master's degree in counseling, Social Work or related program from an accredited college or university.
• Past or active licensure in social work (LICSW, LCSW) or counseling (LMHC, LPC) or marriage and family therapy (LMFT).
• Experience working for an early-stage and / or high-growth behavioral health provider.

Create a job alert for this search

Senior Director Quality • Worcester, MA, US