Quality Manager, Behavioral Health

Job Title: Quality Manager, Behavioral Health

Department: CloseKnit Behavioral Health

Reports to: Senior Director of Behavioral Health Operations

Work arrangement: Virtual

Job Summary

The Quality Manager, Behavioral Health is responsible for developing, implementing, and monitoring quality assurance and quality improvement activities for CloseKnit Behavioral Health. This role supports documentation excellence, regulatory and payer audit readiness, clinical quality monitoring, patient safety, complaint and grievance review, provider support, and performance improvement across therapy and psychiatry services.

The Quality Manager works cross-functionally with behavioral health clinical operations, leadership, providers, compliance, revenue cycle management, credentialing, product, data analytics, customer service, and other teams to ensure behavioral health services are delivered in a high-quality, patient-centered, compliant, and measurable manner.

This position serves as a quality and clinical operations resource to behavioral health providers and operational teams, providing guidance related to documentation standards, evidence-based care, workflow optimization, risk identification, care coordination, and quality improvement opportunities. The Quality Manager identifies trends, recommends corrective action, supports process improvement, and helps establish short- and long-term quality objectives aligned with CloseKnit Behavioral Health goals.

Quality Assurance & Clinical Documentation

• Develop, implement, and manage behavioral health quality assurance and quality improvement processes across therapy and psychiatry services.
• Develop and maintain chart audit processes to evaluate clinical documentation, treatment planning, medical necessity, risk assessment, coding support, and compliance with organizational and payer expectations.
• Monitor documentation timeliness, completeness, and quality; identify trends and partner with clinical and operational leaders to support improvement.
• Conduct documentation reviews and provide clear, actionable feedback to providers to improve consistency, compliance, and quality of care.
• Support development, review, and implementation of behavioral health clinical documentation standards, templates, workflows, and audit tools.

Quality Metrics & Outcomes Monitoring

• Track and evaluate key behavioral health quality metrics, including clinical outcomes, PHQ-9 and GAD-7 measurement cadence, symptom improvement, patient satisfaction, access, complaints, incidents, and provider performance indicators.
• Create and maintain quality scorecards, dashboards, audit tools, reports, and outcome measurement processes in partnership with data analytics and operational teams.
• Analyze quality data to identify trends, barriers, opportunities, and risks; prepare clear summaries with findings, recommendations, and action plans.
• Support longitudinal tracking of patient improvement, provider performance, documentation quality, and behavioral health service line outcomes.

Compliance, Risk & Audit Readiness

• Support payer, regulatory, accreditation, and internal audit readiness activities for behavioral health services.
• Partner with compliance, revenue cycle management, credentialing, IT/product, customer service, and operational teams to identify risks, close process gaps, and strengthen quality controls.
• Review patient complaints, grievances, incident reports, safety concerns, and provider-related quality issues; support investigations and recommend corrective actions as appropriate.
• Support review of adverse events, patient safety concerns, clinical risk matters, and high-risk patient workflows.
• Assist in the development and monitoring of corrective action plans related to documentation, quality, compliance, patient safety, or operational performance concerns.

Provider Support & Clinical Operations

• Collaborate with clinical leadership to support peer review, case review, provider education, documentation feedback, and performance improvement activities.
• Serve as a clinical quality resource and consultant to providers and operational teams regarding documentation standards, evidence-based care, workflow questions, care coordination, and quality improvement opportunities.
• Provide guidance and support regarding complex clinical situations, risk concerns, documentation questions, and high-risk patient management, escalating concerns to clinical leadership when appropriate.
• Support onboarding, training, coaching, and ongoing education of behavioral health providers related to quality expectations, documentation standards, compliance requirements, and clinical workflows.
• Support implementation of standardized workflows for referrals, scheduling, documentation, treatment plan review, high-risk patient management, crisis escalation, care coordination, and follow-up processes.

Process Improvement & Cross-Functional Collaboration

• Lead or participate in quality committees, workgroups, audits, performance improvement projects, and change management initiatives.
• Apply structured problem-solving methods to identify root causes and support sustainable process improvements.
• Work collaboratively with behavioral health operations, clinical leadership, compliance, revenue cycle management, data analytics, product, customer service, and other matrixed teams to improve care delivery and operational performance.
• Support development, review, and implementation of behavioral health policies, procedures, workflows, quality scorecards, outcome measures, and performance monitoring processes.
• Lead and/or participate in additional projects as assigned.

Supervisory Responsibilities

The Quality Assurance Manager may supervise Quality Assurance staff or other designated team members as the Behavioral Health service line grows. Provides leadership, guidance, training, and mentorship to staff and supports accountability for quality-related workstreams.

Required Qualifications

• Bachelor’s degree in healthcare administration, public health, behavioral health, social work, counseling, nursing, psychology, or a related field.
• 5–8 years of relevant experience in healthcare quality management, behavioral health operations, clinical quality assurance, compliance, or related healthcare settings.
• Experience with behavioral health documentation standards, chart audits, treatment plans, medical necessity, risk assessment, and payer audit expectations.
• Knowledge of quality assurance and quality improvement principles, methods, and tools.
• Experience collecting, reviewing, analyzing, and interpreting clinical, operational, and quality data.
• Strong understanding of telehealth, outpatient behavioral health service delivery, and integrated or collaborative care models.
• Ability to develop workflows, audit tools, policies, procedures, reports, scorecards, and improvement plans.
• Strong organizational skills with the ability to manage multiple priorities, deadlines, and cross-functional projects.
• Excellent written and verbal communication skills, including the ability to provide clear documentation feedback and present findings to leadership.
• Ability to work collaboratively with clinical providers, operational leaders, compliance, revenue cycle management, product, data, credentialing, and customer service teams.
• Proficiency with Microsoft Office applications and comfort working with electronic health records and reporting tools.

Preferred Qualifications

• Active clinical license in VA, DC, or MD - LCSW-C, LICSW, LPC, LCPC, LMFT
• Experience delivering behavioral health services via telehealth.
• Experience with Athena or similar electronic health record systems.
• Experience supporting payer audits, regulatory reviews, complaint and grievance processes, incident review, or corrective action plans.
• Familiarity with PHQ-9, GAD-7, outcome measurement, provider performance metrics, and clinical quality dashboards.
• Experience providing clinical consultation, provider support, mentoring, supervision, or quality leadership within behavioral health settings preferred.

Performance Expectations

• Develop and maintain behavioral health chart audit tools, documentation review processes, and quality monitoring workflows.
• Complete periodic chart audits and quality reviews and provide actionable feedback to providers and leadership.
• Monitor documentation timeliness, documentation quality, clinical outcomes, patient satisfaction, complaints, incidents, and provider performance indicators.
• Prepare regular quality reports, scorecards, summaries, and recommendations for behavioral health leadership.
• Support implementation of clinical quality, compliance, patient safety, and performance improvement initiatives.
• Participate in committees, provider education, peer review, case review, and process improvement meetings.
• Support provider onboarding, training, coaching, and ongoing education related to documentation, quality standards, workflows, and payer expectations.
• Identify trends, barriers, risks, and improvement opportunities and support timely follow-up action plans.
• Contribute to behavioral health service line growth, operational consistency, audit readiness, and clinical excellence.