Clinical Integrity Specialist

Job Summary

A company is looking for a Clinical Integrity Specialist to support clinical quality and contract compliance in mental healthcare.

Key Responsibilities

• Lead customer interactions and manage escalations related to fraud and misconduct
• Provide education on policies and procedures to providers and maintain compliance across various areas
• Analyze trends from escalations to enhance clinical quality and operational improvements

Required Qualifications

• 2-3 years of experience in customer experience, operations, strategy, or compliance-related roles
• Proficiency with computer systems, including Google Suite, and familiarity with CRM and project management tools like Zendesk and Asana
• Ability to distill complex communications into actionable steps for various stakeholders
• Strong organizational skills and a customer-centric attitude
• Demonstrated ability to handle sensitive issues and build relationships across diverse groups