Clinical Integrity and Compliance Consultant

About the role

Clinical Integrity and Compliance Consultant (Contract) – Remote position (6‑month contract covering an employee leave) supporting the development and implementation of clinical quality improvement initiatives to strengthen clinical services, compliance, and patient care. The role collaborates with clinical, operational, legal, compliance, and business stakeholders to promote consistent practices across care settings.

Responsibilities

• Manage daily inquiries related to clinical integrity and compliance.
• Support the development, implementation, and management of workflows that strengthen clinical integrity and compliance operations.
• Provide guidance and support on compliance-related matters, including documentation standards and ethical considerations.
• Conduct discovery and provide recommendations regarding clinical compliance issues involving state and federal rules and regulations, including state-specific scope of practice and prescriptive authority requirements for various clinician types.
• Conduct discovery and collaborate cross-functionally on critical incidents and quality-of-care investigations, providing formal conclusions and recommendations.
• Support internal departments and external agencies by responding to board inquiries, payer audit requests, regulatory inspections, and interviews.
• Collaborate with Legal and Compliance teams and clinicians during board complaint investigations.
• Assist with identifying, developing, and managing clinical policies, procedures, and guidelines aligned with accreditation standards such as URAC, Joint Commission, and NCQA.
• Assist with developing and delivering education and training related to clinical compliance concerns.
• Participate in committees related to clinical compliance as assigned.
• Support APP supervisory programs.
• Support therapy supervision protocols.

Requirements

• Master's or doctoral degree in Psychology, Social Work, Counseling, Nursing, or a related field.
• 2+ years of clinical practice experience.
• 2+ years of experience developing and implementing clinical integrity and regulatory policies and procedures.
• 2+ years of experience providing clinical supervision and training to providers within the applicable discipline, such as LCSWs, LPCs, LMFTs, or APPs, preferred.
• Prior experience with a regulatory compliance program within a healthcare delivery or payer organization preferred.
• Demonstrated awareness, inclusivity, sensitivity, humility, and experience working with individuals from diverse ethnic backgrounds, socioeconomic statuses, sexual orientations, gender identities, and other aspects of culture.
• Legally authorized to be employed in the United States (both now and in the future).
• Ability to meet the physical requirements of the role, with reasonable accommodations available for individuals with disabilities.
• W2 only; no C2C.

Pay

$40‑47 per hour