SonderMind

Clinical Specialist

• Conduct prospective, concurrent, and retrospective utilization reviews to assess medical necessity, treatment appropriateness, and level of care
• Apply evidence-based UM criteria to evaluate clinical documentation and support authorization and appeal processes
• Monitor care intensity and utilization trends to identify outliers and inform targeted provider interventions
• Partner with health plans on external UR requests and peer-to-peer review coordination
• Investigate and remediate provider concerns stemming from UM findings, client complaints, or external reports
• Monitor clinical adverse events and apply early-stage risk mitigation in partnership with cross-functional teams
• Support measurement-based care initiatives and identify opportunities to strengthen clinical outcomes across the provider network
• Track utilization metrics, review volumes, and case outcomes to inform quality improvement efforts
• Surface trends and process gaps to leadership and contribute to the ongoing refinement of UM policies and workflows

Part-Time Clinical Quality Specialist

Account Manager

• Manage day-to-day relationships with VAMC Community Care staff, MTF clinic coordinators, and Family Readiness Officers across an assigned territory, serving as a reliable, responsive point of contact for referral coordination, authorization questions, and account needs across both VA CCN and TRICARE channels
• Support Veterans in accessing Community Care Network (CCN) mental health services and TRICARE-covered active duty dependents in accessing in-network behavioral health care — resolving scheduling, onboarding, and access barriers in partnership with internal teams
• Track referral activity and account health across assigned VA and TRICARE sites, escalating patterns and systemic issues to the senior AM and internal programs team
• Train VAMC staff on SonderMind's CCN referral processes and MTF/base clinic staff on TRICARE authorization and scheduling workflows, ensuring all partners can send referrals confidently
• Coordinate with Care Coordination, Provider Success, and Billing teams to resolve account-level issues affecting both VA and TRICARE beneficiaries
• Maintain accurate records of account activity, VAMC and MTF contacts, authorization status, and escalation notes in Salesforce
• Support the senior AM and Head of Military and Government Partnerships with reporting, site-specific insights, and preparation for strategic conversations across both VA and TRICARE accounts

Part-Time Clinical Quality Specialist

Senior VA Account Manager

Clinical Quality Specialist