Clinical Quality Program Manager

Job description

Pelago is the leading specialty substance use care provider, built on the belief that effective treatment means matching care intensity to what each member actually needs rather than defaulting to the most expensive intervention. Our programs guide members through every stage of the substance use spectrum, from unhealthy habits to active use disorders, delivering personalized treatment for tobacco, alcohol, opioid, cannabis, and stimulant use based on individual health, habits, genetics, and goals. With Sona, our voice-first AI Mental Health Specialist, Pelago now applies that same clinically-driven model to mental health, pairing deep clinical expertise with technology to expand access without compromising care quality. We believe technology should make clinical care more precise and more human, not replace the judgment behind it. Pelago has scaled to helping hundreds of employers and health plans and has already helped more than 750,000 members better manage their substance use. If you're passionate about AI and making an impact on the health of others, join us and make it happen! ### **Overview of the Role:** As our Care Quality Program Manager, you'll lead clinical quality and accreditation readiness for Pelago's care programs. You'll run clinical audits across our care team, co-lead our Quality and Safety Committee, and serve as the clinical lead for Joint Commission readiness, from policy development through survey day. You'll be the link between what quality reviews find and what changes as a result. That means turning audit results and committee decisions into updated policies, protocols, and care team tools, then confirming those changes improved care. You'll work closely with clinical managers, our Credentialing, Licensing & Quality Operations Manager, and our product and operations teams. This is a high-ownership role for a clinician ready to shape a function as it grows. **This is a full time remote role, open to candidates located in the United States.** ### **In This Role You Will:** - **Run the Quality and Safety Committee.** Co-lead it with our Credentialing, Licensing & Quality Operations Manager: prepare each meeting, turn discussion into clear decisions and owners, and track whether follow-through actually happens. - **Lead clinical readiness for Joint Commission accreditation.** Own the required clinical policies, run mock audits, drive corrective action on gaps, and serve as the day-of clinical point of contact during surveys. - **Make standards usable.** Translate Joint Commission requirements into practical guidance that clinical managers and the care team can act on. - **Audit clinical work.** Run structured audits of documentation, clinical reasoning, protocol adherence, and member interactions against Pelago's standards, keeping records with integrity and confidentiality. - **Turn findings into action.** Deliver reports managers can use with their teams, with patterns and recommendations, not just observations. - **Fix systemic gaps.** Spot when recurring issues point to gaps in policy, tooling, training, or process; propose updates with clinical, product, and operations partners; and revisit changes to confirm they worked. - **Keep policy compliant.** Maintain working knowledge of the regulatory, licensing, and accreditation requirements behind Pelago's programs so every policy change stays grounded and current. ### **The Background We're Looking For:** **3+ years in clinical quality, compliance, or auditing, including hands-on experience running clinical audits, managing a quality program, and/or preparing for accreditation or regulatory surveys (Joint Commission, CARF, or similar)** - An active, unrestricted clinical license in good standing (e.g., LCSW, LPC, LMFT, RN, or licensed psychologist) - Familiarity with substance use disorder (SUD), mental health, or broader behavioral health care - Proven ability to work independently: you can take a task, run it, and return with clear findings without hands-on management throughout - Strong written communication; audit findings, committee summaries, policy documents, and accreditation materials all live or die on how clearly they're written - Organized and accountable: you track your own follow-through and others' without waiting to be reminded - Comfort with ambiguity and iteration; this role will help define its own scope over time ### **Nice-to-have skills:** - Hands-on experience with Joint Commission standards, accreditation surveys, or healthcare regulatory compliance - Experience with telehealth, distributed care teams, or virtual clinical programs - Experience using AI tools to improve clinical documentation, auditing, or quality workflows ### **What you’ll love about us:** We have a whole host of perks for our people! From life essentials to nice-to-haves, there are more than a few good reasons to love working with us. We strive to ensure Pelago employees have equitable access to healthcare, wellbeing, time away, and then some. - Generous and meaningful equity package - Full Medical, Dental, & Vision coverage - 401k Plan - Unlimited PTO Policy, 10 paid holidays, & company wide “Me Time” Days - Paid maternity, paternity & new parent leave - Flexible working environment - Annual Learning and Development stipend to support continued learning and career development - Wellness Reimbursement Program - Access to Reproductive & Family Planning Care - Substance Use Support for employees and family members The provided range reflects our US target salary range for this full-time position, which is part of our broader total compensation package, including incentive bonus program, stock options, comprehensive benefits, and incentive pay applicable to eligible roles. Individual pay within the range will vary based on a variety of factors like role-related experience and education, internal pay equity, and other relevant business factors. At Pelago, we are committed to an equitable and fair pay philosophy and review total compensation for our employees at least twice a year. Base Pay Range $100,000—$115,000 USD