Clinical Quality Manager

Summary

Join Included Health's Clinical Quality and Safety team as a Clinical Quality Manager (MD, DO, or NP) and contribute to our mission of ensuring everyone has access to top-quality care. Reporting to the Associate Director, you will oversee quality programs, audit care practices, and collaborate with clinical and operational leaders to improve patient outcomes. You will analyze data, address quality concerns, and present findings to internal and external stakeholders. This remote position requires a strong clinical background, data analysis skills, and a commitment to continuous improvement. The ideal candidate is empathetic, proactive, and passionate about enhancing healthcare quality. Competitive salary and benefits are offered.

Requirements

• 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
• This is a remote position, so a reliable high-speed internet connection is required
• 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

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

Preferred Qualifications

• 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
• Enjoy remote flexibility with occasional travel (~5-10%)

Benefits

• Remote-first culture
• 401(k) savings plan through Fidelity
• Comprehensive 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 leave
• Family 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