Senior Director, Clinical Quality

Guidelight; Worcester (MA); Remote; USD 90,000 - 120,000; Full time

Job summary

A leading healthcare company seeks a Senior Director of Clinical Quality to ensure high-quality mental health services and compliance with regulations. This role requires strong leadership, operational experience in a healthcare environment, and a passion for mental health advocacy. Join us in making an impact on behavioral healthcare.

Qualifications

• 3+ years leadership in compliance/quality assurance.
• 6+ years operations experience in healthcare.
• Experience with CMS programs and NCQA accreditation.

Responsibilities

• Oversee compliance with mental health regulations and standards.
• Develop and implement training programs.
• Conduct regular audits and assessments.

Skills

Leadership

Communication

Organizational Skills

Risk Management

Education

Master's degree in counseling or related field

Tools

Microsoft Office

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.
• Risk Management
• 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.