Clinical Lead, Risk Management at Headway

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Remote

Headway’s mission is a big one - to build a new mental health care system everyone can access. We’ve built technology that helps people find great therapists with the first software-enabled national network of providers accepting insurance.

1 in 4 people in the US have a treatable mental health condition, but the majority of providers don’t accept insurance, making therapy too expensive for most people. Headway is building a new mental healthcare system that everyone can access by making it easy for therapists to take insurance and scale their practice.

Headway was founded in 2019 – since then, we’ve grown into a diverse, national network of over 25,000 mental healthcare providers across all 50 states who run their practice on our software. We’re a Series C company with over $225m in funding from a16z (Andreessen Horowitz), Accel, GV (formerly Google Ventures), Spark Capital, Thrive Capital, and Health Care Service Corporation.

We want your time here to be the most meaningful experience of your career. Join us, and help change mental healthcare for the better.

As a Clinical Lead (Risk Management team), you will be responsible for executing and evolving Headway’s internal Provider Risk Management program, including investigations into Fraud, Waste, and Abuse, and associated provider remediation and coaching. You’ll also work cross-functionally with our Product, Operations, and CX teams to shape product development to align with our key initiatives.

As the only tech-enabled behavioral health Managed Services Organization (MSO) built with entirely in-house software, Headway has an unprecedented opportunity in the clinical space. Today, we support more than 26k Clinicians and hundreds of thousands of patients. Building a best-in-class digital product will impact clinicians and patients nationwide.

You Will:

Evaluate and improve Headway’s coding and billing policies, ensuring compliance with all Payer, state and federal regulations
Implement the process and policies associated with managing Fraud, Waste, Abuse at Headway
Review claims filing data to identify patterns to inform our internal coding policies
Have boots on the ground, working directly with Providers to educate them and change behavior in service of improving compliance
Ensure the quality and accuracy of our internal audit team
Support continuous and scalable auditing processes
Work closely with cross-functional teams to partner on policy changes and rollout in service of reducing fraud, waste, and abuse
Collaborate with our product and engineering teams to ensure our tools and systems are optimized for compliant coding and documentation behavior
Contribute to strategic planning, direction, and goal setting for the Provider Operations team

You’ll be great for this role if:

You have 3+ years of clinical operations/administration experience in areas such as quality improvement, utilization management, compliance or related experience in behavioral health
You are a licensed behavioral health clinician
You are a thought leader – with demonstrated passion for reimagining how provider performance is measured, identified, and resolved.
You are a collaborator – eager and adept at working in concert with product, operations, and sales teams to infuse clinical strategy across the org
You have cross-functional experience - working with interdisciplinary teams from Legal to Compliance to Product or Engineering
Nice to have:
- Experience at a high-growth technology start-up
- You are maintaining a small practice
- You have experience in merging technology and healthcare
- You are a certified expert coder - AHIMA or AAPC

Compensation and Benefits:

Salary information is based on a single salary target per role and is differentiated based on geographic location (Group A, B, or C)
- Group A: $150,000
- Group B: $135,000
- Group C: $120,000
- Examples of cities located in each Compensation Grouping:
  - Group A = NYC, SF/Bay Area, LA Area, Seattle, Boston, Austin, and San Diego
  - Group B = Chicago, Miami, Denver, Washington DC, Philadelphia, Atlanta, Minneapolis, Nashville, Sacramento, Phoenix, and Portland
  - Group C = All remaining cities

Benefits offered include:
- Equity Compensation
- Medical, Dental, and Vision coverage
- HSA / FSA
- 401K
- Work-from-Home Stipend
- Therapy Reimbursement
- 16-week parental leave for eligible employees
- Carrot Fertility annual reimbursement and membership
- 13 paid holidays each year as well as a Holiday Break during the week between December 25th and December 31st
- Flexible PTO
- Employee Assistance Program (EAP)
- Training and professional development

We believe a team's strength is in its people, and we cannot achieve this mission without a team that reflects the diversity of this problem - across race, ethnicity, gender, sexuality, age, national origin, religion, family status, disability, military status, and experience.

Headway is committed to the full inclusion of all qualified individuals. As part of this commitment, Headway will ensure that persons with disabilities are provided with reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or receive other benefits and privileges of employment, please contact talent@findheadway.com

Headway employees work remotely across the US, with the option to work from offices in New York City and San Francisco. Headway participates in E-Verify. To learn more, click here.

Estimated Salary range:

Our salary intelligence, powered by our AI algorithms, has calculated an estimated range for this position between $85,000 - $110,000 . Please note that the actual salary for this position may vary, as it is dependent on various factors including but not limited to experience, location, and market dynamics.

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