Associate Clinical Director, Integrated Care Quality (NP/MD)

1 month, 2 weeks ago
Full-time
Lead
Data Science and Analytics
Included Health

Included Health

Included Health is a healthcare company that provides cost-saving solutions for employers and health plans. They offer virtual care and navigation services, connecting millions with board-certified doctors and specialists for comprehensive and convenie...

Insurance
1K-5K
$106M raised

Description

  • Represent clinical services in high-stakes client, consultant, health plan, and audit-related discussions.
  • Build trusted relationships with clients, consultants, health plans, and internal commercial partners.
  • Serve as a clinical quality voice in escalations, performance reviews, corrective action discussions, and executive forums.
  • Own the strategy and operating model for clinical client audit readiness.
  • Lead audit planning, preparation, risk triage, file review standards, and executive readiness.
  • Serve as the senior clinical lead for audit content, responses, and remediation planning.
  • Translate audit findings into measurable action plans with clear ownership and follow-through.
  • Lead the design and maturation of longitudinal quality assurance models across the member journey.
  • Build proactive oversight frameworks that identify risks before they surface in audits or escalations.
  • Use AI and advanced analytics to scale quality surveillance, longitudinal review, and audit readiness.
  • Partner with product, engineering, analytics, and AI quality leaders to build safe, clinically credible workflows.
  • Own population health quality oversight across relevant clinical programs and improve performance over time.
  • Establish and govern a metric framework covering clinical quality, operational performance, service reliability, and member outcomes.
  • Translate performance findings into corrective plans, workflow redesign, policy refinement, and program accountability.

Requirements

  • Physician or Nurse Practitioner with a current unrestricted U.S. license in good standing.
  • Board certification required for physicians.
  • 7+ years of clinical, healthcare quality, patient safety, or clinical operations experience with progressive responsibility.
  • 3+ years of experience leading or shaping client-facing quality work, external audits, consultant engagement, or similar high-stakes external clinical work.
  • Experience representing clinical services in meetings with clients, consultants, auditors, health plans, or senior executives.
  • Strong experience in quality strategy, audit readiness, program development, and cross-functional leadership.
  • Excellent written and verbal communication skills with the ability to tailor messaging to clinicians, clients, consultants, and executives.
  • Strong analytical and systems-thinking skills with comfort interpreting quality and operational data.
  • Proven ability to build relationships, influence without authority, and lead through ambiguity.
  • Preferred experience in population health, care navigation, care management, virtual care, or other longitudinal care models.
  • Preferred experience designing or leading longitudinal QA or proactive surveillance models.
  • Preferred experience leveraging agentic AI or advanced analytics to scale quality oversight.
  • Familiarity with external quality or accreditation frameworks such as URAC, NCQA, HEDIS, or MIPS.
  • Experience with tools such as Looker, Tableau, Observe.AI, or advanced spreadsheet analysis.
  • CPHQ, CPPS, Lean Six Sigma, or similar training/certification.

Benefits

  • Remote-first culture.
  • 401(k) savings plan through Fidelity.
  • Comprehensive medical, vision, and dental coverage, including disability insurance.
  • Paid Time Off (PTO) and Discretionary Time Off (DTO).
  • 12 weeks of 100% paid parental leave.
  • Family-building and compassionate leave, including fertility coverage and surrogacy/adoption support.
  • Work-from-home reimbursement to support home office collaboration.
  • Bonus, equity, and benefits in addition to base salary.

Interested in this position?

Apply directly on the company website

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