Clinical Quality Specialist (PT)
Dallas, Texas, United StatesAll locationsDallas, Texas, United StatesDenver, Colorado, United StatesSalt Lake City, Utah, United StatesAtlanta, Georgia, United StatesRaleigh, North Carolina, United StatesCharleston, South Carolina, United StatesSeattle, Washington, United StatesIndianapolis, Indiana, United StatesBoston, Massachusetts, United StatesJacksonville, Florida, United StatesAustin, Texas, United StatesSan Antonio, Texas, United StatesBoise, Idaho, United StatesHouston, Texas, United StatesTampa, Florida, United StatesOrlando, Florida, United StatesScottsdale, Arizona, United States Remote
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About the role
The part-time Clinical Quality Specialist role exists to safeguard and strengthen the clinical integrity of care delivered across the organization, with a focused lens on utilization management, payor-facing clinical audits, and clinical quality assurance. This position ensures that care is medically necessary, appropriately documented, and aligned with evidence-based standards and payor requirements supporting both provider success and defensible, compliant clinical operations. This is a collaborative, provider-supportive role that combines sound clinical judgment with the rigor of utilization review and audit-readiness. The Specialist serves as a key bridge between clinical care, payor expectations, and internal quality standards. This is a part-time role up to 30 hours per week. The schedule is flexible, during normal business hours in your time-zone, during the week.
What you'll bring
- Master’s degree in a mental health discipline.
- Active, cleared clinical license (e.g., LMFT, LPC, LCSW, LMHC, or equivalent) in good standing.
- Experience in utilization management, utilization review, medical necessity review, or clinical auditing
- Familiarity with payor requirements, medical necessity criteria, and level-of-care guidelines.
- Strong clinical judgment and experience handling escalations, adverse events, or quality-related investigations.
- Demonstrated ability to produce clear, accurate, and defensible clinical documentation.
- Demonstrated ability to collaborate effectively across multiple teams.
- Commitment to provider support and quality management.
- Familiarity with clinical technology platforms for documentation, case tracking, and data analysis to support provider quality and compliance.
- ideally in a behavioral health or payor/health plan context.