Clinical Quality – Regulatory Leader

🕒 2 days ago

🇺🇸 United States – Remote

💵 $110k - $125k / year

⏰ Full Time

🟠 Senior

🚔 Compliance

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LifeStance Health

WebsiteLinkedInAll Job Openings

5001 - 10000 employees

💼 Consulting

🛡️ Insurance

🏥 Healthcare

💰 Private Equity Round on 2016-12

Consulting • Insurance • Healthcare

LifeStance Health is a provider of comprehensive mental health services, offering care through in-person and telehealth appointments for various mental health conditions such as anxiety, depression, ADHD, and more. With a large network of licensed clinicians, including psychiatrists, psychologists, and therapists, LifeStance Health tailors care plans to fit individual needs. The company accepts a wide range of insurance plans, making mental health care accessible to a broad audience. Services include therapy, psychiatric evaluations, medication management, and psychological testing across numerous states.

📋 Description

• Serve as the clinical quality lead for an assigned portfolio of regions on behalf of the Chief Medical Office • Manage, triage, and investigate critical incidents • Coordinate multidisciplinary investigations with practice operations, clinical operations, HR, legal, and compliance leaders • Bridge investigation findings with credentialing, peer review, Medical Executive, practice operations, and clinical operations committees • Aggregate incident reports, patient safety events, quality concerns, and quality metrics to identify trends • Work with area leaders to use data and trends to improve regional quality of care • Design and implement corrective actions and training programs addressing identified risks and preventing adverse events • Monitor and evaluate corrective actions and quality improvement initiatives through measurement, outcome analysis, and follow-up • Report regional quality, safety, and regulatory findings to the Chief Medical Office, Practice Operations, and Clinical Operations • Support morbidity and mortality rounds • Drive enterprise initiatives related to patient safety, clinical quality, regulatory compliance, and accreditation • Support adherence to state and federal requirements, accreditation standards, and company policy through chart audits • Support survey and state audit preparation and follow through on corrective action plans • Conduct site visits as needed for survey support • Review clinical documentation against payer expectations and medical necessity requirements • Support payer audit outcomes through chart audits and action plans • Travel up to 50% to assigned regions, with periodic travel to Chief Medical Office and enterprise leadership meetings

🎯 Requirements

• Master's degree in a behavioral health discipline, nursing, a related clinical field, or relevant experience • Five or more years delivering or overseeing behavioral health services, with direct exposure to clinical documentation standards and chart review • Active, unrestricted clinical license preferred but not required • Experience conducting or supporting investigations of adverse events, quality of care concerns, or grievances • Ability to interpret regulatory and accreditation requirements and translate them into practical guidance • Working fluency with data, including building and interpreting trend reports • Excellent written and verbal communication and presentation skills • Ability to manage competing priorities across multiple regions in a fast-paced, matrixed environment • Legally authorized to be employed in the United States • Joint Commission or state licensure survey experience preferred • Exposure to Lean or Six Sigma methodologies preferred • CPHQ or comparable quality credential or experience preferred • Experience with focused and ongoing professional practice evaluation, peer review support, or credentialing and privileging preferred • Multi-state or multi-site behavioral health experience, including payer audits and medical necessity documentation review preferred • Residence within one of the regions this position will support preferred • Ability to sit, stand, bend, talk, hear, walk while on site, and lift or move objects up to 25 pounds • Specific vision abilities including close, distance, peripheral vision, depth perception, and ability to adjust focus

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • AD&D insurance • Short- and long-term disability insurance • Life insurance • 401k retirement savings with employer match • Paid parental leave • Paid time off • Holiday pay • Employee Assistance Program • Competitive bonus plan

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