Clinical Quality & Compliance Specialist

Required Job Overview We're looking for a Clinical Quality & Compliance Specialist to help elevate the quality of clinical documentation, support therapists in delivering high-quality care, and ensure compliance across our clinical operations. This role sits at the intersection of clinical expertise, coaching, compliance, and quality improvement. You will audit clinical documentation, provide actionable feedback to therapists, manage clinician complaints and compliance matters, ensure our EMR meets regulatory and payor requirements, and identify trends that inform training, system improvements, and scalable quality frameworks across the organization. This is not a compliance policing role—it's a supportive, educational, and impact-driven position focused on helping therapists succeed while maintaining high standards. As our network grows, this role has a clear path to shaping how clinical quality is defined and measured at scale.

Essential Functions & What You'll Own:

1. Clinical Documentation Auditing Own the clinical quality audit process across the network, conducting structured reviews of clinical documentation including: Intakes and biopsychosocial assessments Diagnoses and medical necessity determinations Treatment plans and measurable goals Progress notes (accuracy, uniqueness, and clinical appropriateness) Ensure documentation meets clinical best practices, payer requirements, and internal quality standards. Track deficiencies, identify patterns across clinicians and cohorts, and maintain clear, consistent audit frameworks and scoring criteria. 2. Clinician Feedback & Coaching Provide clear, actionable, and constructive feedback to therapists—translating audit findings into practical improvements they can implement immediately. Follow up on audits to ensure improvement and lasting behavior change, balancing high standards with a supportive, therapist-first approach. Build trust with clinicians while holding expectations is central to this work. 3. Clinical Consultation & Training Serve as a go-to resource for real-world clinical and documentation questions, providing guidance on: Documentation of complex or high-risk situations (e.g., suicidality, crises) Ethical considerations (e.g., treating multiple family members, boundaries) Case closure, referrals, and coordination of care Develop and deliver training on documentation standards, common audit deficiencies, and best practices for quality and compliance. This includes creating guides, templates, and resources for clinicians, supporting onboarding audits for new clinicians, and partnering with leadership to align training with observed trends. 4. Quality Improvement & Trend Analysis Analyze audit data to identify systemic documentation gaps, opportunities for standardization, and training needs across the network. Translate those insights into process improvements, documentation updates, and training initiatives—and track the impact of those changes over time. Contribute to the evolution of our quality infrastructure, including EHR templates, workflows, and tools. As technology and automation reshape clinical quality monitoring, assist with evaluating and shaping how new tools are deployed responsibly to improve care quality at scale. 5. Compliance & Regulatory Support Play a key role in maintaining compliance across clinical operations, including: Handling and resolving clinician and licensure complaints through investigation, documentation, and appropriate follow-through Identifying and managing compliance violations, supporting corrective action plans, and ensuring alignment with regulatory requirements Ensuring the EMR system remains compliant with payor requirements, including documentation templates, billing configurations, and clinical workflows Maintaining current ICD code updates in the EMR, coordinating timely implementation of code set changes to support accurate diagnosis and billing

What You Bring:

Experience Required Master's degree in Social Work, Counseling, Psychology, or a related field Active, independent clinical license (LMSW, LPC, LP, or equivalent) 5+ years of clinical experience, preferably in private practice or outpatient settings Experience with clinical documentation standards and payer requirements Knowledge of ICD coding, medical necessity, and insurance compliance expectations Strong clinical judgment and attention to detail Excellent written communication skills Ability to give feedback in a way that drives improvement, not defensiveness Preferred 8+ years of clinical experience Experience in QA, auditing, clinical supervision, or training Experience handling clinician complaints, licensure issues, or regulatory compliance matters Familiarity with EHR systems, quality monitoring workflows, or technology-enabled clinical tools Analytical mindset—you see patterns, not just one-off problems

Benefits:

401(k) 401(k) matching Dental insurance Flexible spending account Health insurance Health savings account Life insurance Paid time off Parental leave Retirement plan Vision insurance Application Question(s): Please provide the best phone number and email to reach you.

Work Location:

Hybrid remote in Troy, MI 48084