Senior Clinical Quality Manager, AI Transformation

Reporting to the Senior Director of Clinical Quality and Safety on the Medical Affairs team, the Senior Clinical Quality Manager - AI Transformation is responsible for leading strategic quality initiatives that strengthen provider performance, clinical quality, and operational excellence across Spring Health's provider network. This role partners cross-functionally with Clinical Leadership, Provider Operations, Product, Business Intelligence, Credentialing, Legal and Compliance, and other teams to design scalable quality programs, optimize workflows, develop provider enablement resources, and drive continuous improvement across quality systems.

This role combines clinical expertise, operational leadership, and systems thinking to improve how quality is measured, managed, and scaled. The ideal candidate is an innovative, highly collaborative leader who excels at translating complex operational challenges into sustainable solutions and embraces an AI-first mindset to improve efficiency, streamline workflows, and enhance decision-making across the Quality organization.

• Lead complex cross-functional initiatives from strategy through implementation using AI-first technology solutions, optimizing automations and intelligent decision support:
• Transform provider policies, SOPs, playbooks, and clinical resources into engaging, interactive tools aimed to improve provider care quality and effectiveness and help them maintain compliance with all legal, regulatory, and payer requirements
• Innovate provider performance feedback tools to amplify provider strengths, address risks and areas for improvement, offer focused education and ongoing professional development to hone their skills, and equip them with resources and actionable steps to achieve these goals
• Design scalable quality team operational workflows that improve efficiency, reduce manual work, and enhance provider experiences.
• Drive systems integrations across enterprise tools to strengthen monitoring of quality improvement initiatives that drive care delivery outcomes and identify strategic opportunities for continuous improvement
• Assist in developing reporting standards for compliance and quality of care, including establishing review criteria and recommending new innovations in processes to better evaluate success
• Develop and maintain policies that support compliance with accreditation and regulatory standards (e.g., CARF, NCQA).
• Serve as a strategic leader in Fraud, Waste, and Abuse (FWA) prevention initiatives.
• Lead and/or participate in additional projects as assigned.