At Included Health, the Associate Clinical Director, Integrated Care Quality (NP/MD) is responsible for the strategy, external representation, and program leadership needed to ensure our clinical services perform credibly in high-stakes client, consultant, and audit-facing settings.
This role leads the clinical quality approach to client audits, consultant engagement, and longitudinal quality assurance across relevant services. The Director will represent Included Health in consequential meetings with clients, consultants, health plans, and internal leaders; shape the vision for external-facing clinical quality work; build trusted relationships; and translate audit and quality findings into durable operational improvement strategies.
Establishing a robust longitudinal oversight process is a primary objective for this position. This leader will drive the development of systems to monitor member journeys, ensure care quality, and maintain service reliability over time. Furthermore, they will utilize AI-driven quality surveillance and pattern detection to modernize and scale quality operations.
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.
Required:
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.
Preferred:
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.
Core competencies:
Strong clinical judgment; systems thinking.
Analytical rigor; documentation excellence.
Risk identification/mitigation in tech-enabled care.
Coaching/influencing across clinical and technical teams.
Leads through ambiguity; works independently.
Key Compentencies:
Executive presence and clinical credibility
Client and consultant relationship management
Strategic thinking and program development
Audit leadership and remediation planning
Longitudinal quality assurance
AI-enabled quality scaling
Analytical rigor
Cross-functional influence
Clear, persuasive communication
Why Join Us
This role is an opportunity to shape how Included Health shows up externally on clinical quality while building the internal systems needed for a more proactive, scalable, and AI-enabled future. You will help strengthen client confidence, improve audit performance, and raise the standard of longitudinal quality oversight across the organization.
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