Clinical Quality Specialist

SonderMind

Clinical Quality Specialist ensuring clinical integrity and compliance in mental health care at SonderMind. Responsibilities include utilization management, provider support, and quality assurance.

Posted 6/24/2026full-timeRemote • Colorado • 🇺🇸 United StatesMid-LevelSenior💰 $72,000 - $82,000 per yearWebsite

About the role

Key responsibilities & impact

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

Requirements

What you’ll need

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 — ideally in a behavioral health or payor/health plan context.
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.

Benefits

Comp & perks

A generous PTO policy, with a minimum of three weeks off per year
A holiday schedule that follows standard U.S. holidays
Free therapy coverage benefits to ensure employees have access to the care they need (must be enrolled in a qualifying medical plan to participate)
Competitive Medical, Dental, and Vision coverage, with plans to meet every need — including HSA (with $1,100 company contribution) and FSA options
Employer-paid short-term disability, long-term disability, life & AD&D, plus coverage of the salary difference for up to seven weeks of short-term disability leave (after the required waiting period)
Eight weeks of paid Parental Leave; if the parent also qualifies for STD, this benefit is in addition, allowing for 8–16 weeks of paid leave
401(k) retirement plan with 100% match on up to 4% of base salary, immediately vested
Join teammates from across the country at our annual company gathering
Company shutdown between Christmas and New Year’s
Supplemental life insurance, pet insurance, commuter benefits, and more

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

utilization managementutilization reviewmedical necessity reviewclinical auditingclinical documentationquality improvementrisk mitigationmeasurement-based caredata analysisprovider interventions

Soft Skills

clinical judgmentcollaborationcommunicationproblem-solvingescalation handlingprovider supportquality managementleadershipinterpersonal skillsattention to detail

Certifications

Master’s degree in mental health disciplineLMFTLPCLCSWLMHCclinical license in good standing