Clinical Quality Manager

Job Summary:At Included Health, we're redefining healthcare to ensure everyone has access to top-quality care. Our Clinical Quality and Safety team contributes in this mission.As a Clinical Quality Manager (MD, DO, or NP), directly reporting to our Associate Director, Clinical Quality. You'll oversee quality programs, audit care practices, and collaborate with clinical and operational leaders to improve outcomes. You'll also address quality concerns, respond to complaints, and share your team's impact with internal and external audiences.This role is ideal for clinicians who excel at addressing challenges, data-driven decisions, and cross-team collaboration. If you're empathetic, proactive, and passionate about raising the bar for healthcare, we'd love to hear from you.
#LI-Remote

Responsibilities

• Administer quality programs across service lines or populations, collaborating with clinical operations managers to address risks and lead improvements.
• Partner with Health Economics, Research, and Clinical Affairs teams to refine clinical effectiveness measures.
• Analyze clinical quality data, including documentation reviews, patient outcomes, satisfaction, and call evaluations.
• Perform and audit case and call reviews to ensure consistent, high-quality feedback.
• Identify improvement opportunities and work with management, training, and operations teams to implement solutions.
• Investigate and address complaints, quality issues, and patient safety events, participating in RCA2 processes.
• Support training plans by defining relevant goals for specific services or populations.
• Represent clinical quality in client meetings, audits, and internal presentations, contributing to top priority areas.
• Collaborate with the credentialing team to support committee activities and recommend performance improvement plans.
• Uphold security and HIPAA regulations, modeling our culture and values in all work.

Qualifications

• Physician or NP with a current unrestricted US license and 3+ years of experience
• Board certification required for physicians
• At least 1 years experience in a healthcare quality role or 3 years experience in progressively responsible leadership roles
• Licensed and in good standing with state medical board(s)
• Be able to write and communicate medical information at a level appropriate to different audiences, including other clinicians, patients, analysts/data scientists, and executives.
• Prior experience in healthcare quality or CPHQ is valued
• Prior experience with analysis and reporting software (Looker, Tableau) or advanced features of spreadsheets (can perform complex functions)
• Be systems-oriented, analytical, and understand how the different parts of the healthcare system work together (or don't) to produce an observed result.
• Agile and comfortable with working in an environment that values change.
• Continuous improvement mindset and willingness to teach and to learn from other members of the team
• This is a remote position, so a reliable high-speed internet connection is required.
• Enjoy remote flexibility with occasional travel (~5-10%)

Physical/Cognitive Requirements

• Prompt and regular attendance at assigned work location.
• Capability to remain seated in a stationary position for prolonged periods.
• Eye-hand coordination and manual dexterity to operate keyboard, computer and other office-related equipment.
• No heavy lifting is expected, though occasional exertion of about 20 lbs of force (e.g., lifting a computer \/ laptop) may be required.
• Capability to work with leadership, employees, and members in an appropriate manner.

• 
  

Pay:The United States new hire base salary target ranges for this full-time position are:
Zone A: $149,450- 211,100 + equity + benefits Zone B: $171,868- 242,770+ equity + benefits Zone C: $186,813-263,880 + equity + benefits Zone D: $194,285-274,430+ equity + benefits
This range reflects the minimum and maximum target for new hire salaries for candidates based on their respective Zone. Below is additional information on Included Health's commitment to maintaining transparent and equitable compensation practices across our distinct geographic zones.
Starting base salary for you will depend on several job-related factors, unique to each candidate, which may include education; training; skills; years and depth of experience; certifications and licensure; our needs; internal peer equity; organizational considerations; and understanding of geographic and market data. Compensation structures and ranges are tailored to each zone's unique market conditions to ensure that all employees receive fair and great compensation package based on their roles and locations. Your Recruiter can share your geographic zone upon inquiry.
Benefits & Perks:In addition to receiving a great compensation package, the compensation package may include, depending on the role, the following and more: Remote-first culture401(k) savings plan through FidelityComprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)Paid Time Off ("PTO") and Discretionary Time Off ("DTO") 12 weeks of 100% Paid Parental leaveFamily Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies.Work-From-Home reimbursement to support team collaboration home office work
Your recruiter will share more about the salary range and benefits package for your role during the hiring process. Apply