Note: The job is a remote job and is open to candidates in USA. Included Health is a new kind of healthcare company, delivering integrated virtual care and navigation. The Associate Clinical Director, Integrated Care Quality (NP/MD) is responsible for the strategy, external representation, and program leadership needed to ensure clinical services perform credibly in high-stakes settings.
Responsibilities
- Represent Included Health clinical services in high-stakes client, consultant, and audit-related discussions
- Build strong relationships with clients, consultants, health plans, and internal commercial partners
- Serve as a trusted clinical quality voice in escalations, performance reviews, corrective action discussions, and executive forums
- Translate complex clinical and operational issues into clear, credible, executive-ready narratives
- Own the strategy and operating model for clinical client audit readiness
- Lead audit planning, preparation, risk triage, file review standards, and executive readiness
- Serve as the senior clinical lead for audit content, responses, and remediation planning
- Ensure audit findings are converted into measurable action plans with clear ownership and follow-through
- Lead the design and maturation of longitudinal QA models that assess quality across the member journey
- Build proactive oversight frameworks that identify risks before they surface in audits, escalations, or client dissatisfaction
- Connect quality findings across service lines to identify systemic issues, not isolated defects
- Ensure longitudinal QA informs coaching, workflow redesign, policy refinement, and client readiness
- Lead the use of AI and advanced analytics to scale quality surveillance, longitudinal review, and audit readiness
- Define where AI can responsibly augment human review, including trend detection, review prioritization, and documentation assessment
- Partner with product, engineering, analytics, and AI quality leaders to build safe, clinically credible workflows
- Ensure AI-supported quality programs maintain strong human oversight, validation, and calibration
- Own population health quality oversight across relevant clinical programs, with accountability for defining, monitoring, and improving program performance
- Establish and govern a metric framework spanning clinical quality, operational performance, service reliability, and member outcomes
- Define metric ownership, thresholds, escalation triggers, and review cadences in partnership with clinical, operational, analytics, and client-facing leaders
- Translate performance findings into concrete action, including corrective plans, workflow redesign, policy refinement, and program accountability
- Build scalable oversight processes that connect longitudinal QA, audit findings, escalations, and program data into a unified view of quality across the member journey
Skills
- Physician or Nurse Practitioner with current unrestricted U.S. license in good standing
- Board certification required for physicians
- 7+ years of clinical, healthcare quality, patient safety, or clinical operations experience with progressive responsibility
- 3+ years of experience leading or materially shaping client-facing quality work, external audits, consultant engagement, or similar high-stakes external clinical work
- Demonstrated experience representing clinical services in consequential syncs with clients, consultants, auditors, health plans, or senior executives
- Strong experience in quality strategy, audit readiness, program development, and cross-functional leadership
- Excellent written and verbal communication skills, with the ability to tailor messaging to clinicians, clients, consultants, and executives
- Strong analytical and systems-thinking skills, with comfort interpreting quality and operational data
- Proven ability to build relationships, influence without authority, and lead through ambiguity
- Experience in population health, care navigation, care management, virtual care, or other longitudinal care models
- Experience designing or leading longitudinal QA or proactive surveillance models
- Experience leveraging agentic AI or advanced analytics to scale quality oversight
- Familiarity with external quality or accreditation frameworks such as URAC, NCQA, HEDIS, or MIPS
- Experience with tools such as Looker, Tableau, Observe.AI, or advanced spreadsheet analysis
- CPHQ, CPPS, Lean Six Sigma, or similar training/certification
Benefits
- Remote-first culture
- 401(k) savings plan through Fidelity
- Comprehensive medical, vision, and dental coverage through multiple medical plan options (including disability insurance)
- Paid Time Off ("PTO") and Discretionary Time Off ("DTO")
- 12 weeks of 100% Paid Parental leave
- Family Building & Compassionate Leave: Fertility coverage, $25,000 for surrogacy/adoption, and paid leave for failed treatments, adoption or pregnancies.
- Work-From-Home reimbursement to support team collaboration home office work
Company Overview