Clinical Operations Specialist - Licensed Therapist

About the role

Employment Type: Full-time, Salaried. Reports To: Clinical Director. Location: Remote/Hybrid. Role Type: Licensed Clinician. Caseload: No Caseload Requirement. The Clinical Operations Specialist is a licensed therapist who provides critical support to clinical operations, leveraging their expertise to address issues involving patients, providers, documentation, quality, and care delivery. This role acts as a bridge between clinicians and the organization’s operational, product, quality, credentialing, and care-coordination teams. Other duties may be assigned as needed.

Responsibilities

• Serve as a clinical resource for member issues requiring clinical judgment
• Support pre-intake clinical review and outreach as needed
• Review and follow up on member feedback requiring clinical attention
• Manage rematch escalations and assist with enrollment-related clinical questions
• Collaborate with the User-Success team to address member needs
• Handle clinical escalations beyond the scope of non-licensed operations staff
• Conduct consultation hours as needed
• Participate in clinical interviews during periods of active hiring
• Address documentation issues requiring clinical interpretation or provider-to-provider communication
• Support clinical review of incomplete or missing diagnoses
• Participate in clinical quality initiatives and audits
• Support and educate providers on clinical documentation standards
• Participate in payer and similar clinically-oriented audits
• Collaborate on quality-improvement initiatives
• Review caseload and documentation integrity
• Work with Product and Clinical Leadership on workforce and quality metrics
• Use internal reporting and quality-monitoring tools
• Interpret metrics for full-time/part-time providers
• Identify trends in clinical quality and areas needing follow-up
• Partner with technical teams as reporting and automation tools evolve
• Represent Clinical Operations in cross-functional meetings (Clinical x Product, User-Success x Clinical, team meetings, Credentialing/Quality Committees, organizational meetings)
• Serve as a clinical liaison to other departments requiring clinical expertise
• Assist with manual rescheduling of medication-management follow-ups when necessary
• Address exceptions to automated medication-management workflows
• Support resolution of escalated prior-authorization issues
• Handle documentation requests (e.g., FMLA, short-term disability) needing clinical review
• Draft physician-facing documentation for review and signature
• Coordinate member communication about documentation appointments
• Support related scheduling changes
• Identify and propose improvements to clinical workflows
• Collaborate with Product and Engineering for clinical input
• Translate clinician and patient needs into operational or product requirements
• Participate in clinical process redesigns and special projects needing clinical expertise
• Help develop scalable clinical workflows as the organization grows
• Other Clinical Duties as Required

Qualifications