Quality Improvement Lead

About Lyra Health
Lyra Health is a leading provider of evidence-based mental health care, serving more than 20 million people globally in partnership with employers and more than 100 million through health plan and partner relationships. The company has delivered more than 15 million sessions of mental health care, published more than 35 peer-reviewed studies, and delivered unmatched outcomes in terms of access, clinical effectiveness, and cost efficiency. Extensive peer-reviewed research confirms Lyra’s transformative care model helps people recover twice as fast and results in a 26% annual reduction in overall healthcare claims costs. Lyra is transforming access to life-changing mental health care through Lyra Empower, the only fully integrated, AI-powered platform combining the highest-quality care and technology solutions.

About the Role
Lyra Health is looking for a Quality Improvement Lead to support our Clinical Quality Department and ensure high-quality, safe, and compliant care. This role supports continuous survey readiness and adherence to regulatory and accreditation standards (e.g. The Joint commission Behavioral Health Care and Human Services standards), and is responsible for enhancing care, safety and operational efficiency by analyzing data, identifying areas for improvement and implementing evidence-based strategies. They play a key role in fostering a culture of continuous improvement across our organization and guide cross-functional teams in improving program performance.

Responsibilities:
Lead Behavioral Health Performance Improvement activities, track performance trends and incidents, conduct Root Cause Analysis, and ensure high quality and culturally responsive care. Lead continuous survey readiness activities (mock surveys, tracer methodology) for external audits, interpret and operationalize regulatory requirements into clinical workflows and policies, ensure contracted services meet accreditation standards, and ensure ongoing compliance with all applicable regulations and standards (e.g., The Joint Commission Behavioral Health standards). Conduct chart audits for timely assessments, treatment plans, medical necessity, and discharge planning, identify risks and implement corrective actions, and partner with supervisors on provider documentation issues Track key metrics, support Ongoing Professional Practice Evaluation (OPPE) and Focused Professional Practice Evaluation (FPPE) processes for licensed providers, and develop dashboards and reports for leadership review. Educate staff on documentation, risk assessment, incident reporting, and quality improvement processes, support competency validation, and address performance gaps with leadership. Coordinate Behavioral Health Quality/Performance Improvement Committee, partner with Risk Management/Compliance on investigations and mitigation strategies, and support Performance Improvement plan development and annual evaluation. Analyze, develop and monitor clinical QI activities to ensure compliance with customer guarantees and lead clinical quality audits with benefits and customer teams Investigate and resolve behavioral health quality of care complaints and grievances Other duties as assigned

Competencies:
Knowledge Clinical Knowledge: A strong understanding of mental health conditions, empirically supported treatment options, and patient progress evaluation. Knowledge of Cultural Factors: Ability to recognize cultural, linguistic, and socioeconomic differences in client populations and sharing this information with the interprofessional team to ensure accurate communication with diverse clients, families and needs. Virtual Platforms and Remote Services: Ability to interact through secure virtual platforms. Ability to maintain the integrity, privacy, and security of private and confidential data in a virtual health care setting. Detail Oriented/Documentation: Proficiency with utilizing Electronic Health Record(s), and other platforms as needed, and attention to ensuring all verbal and written communication is accurate, private, and secure. Ensure accuracy and timeliness in submitting documentation within the electronic health record. Practice Based Learning & Improvement Utilize Scientific Evidence in Practice: Stay up to date on all required and applicable, role, program, and company training. Adaptability to Technologies: Flexibility in learning new technologies and staying up-to-date on advances in virtual healthcare delivery. Self Assessment and Reflection: Ability to think critically and adjust processes in real-time when needed, consulting with the interprofessional team if modifications are required based on client needs. Interpersonal and Communication Collaboration and Interprofessional Communication: Strong ability to work collaboratively with supervisors, team leads, and other clinical staff, contributing to the development and execution of communication, services, and plans. Ability to effectively coordinate with interprofessional teams to communicate updates and adapt communication as needed. System Based Practice Awareness of System: Understands systems policies, protocols, and processes, and demonstrates compliance, as evidenced by ability to verbalize, or explain policies, protocols, and processes and knowledge how systems support access and care. Promoting Safety and Quality: Works effectively within a team to enhance patient safety and improve the quality of care, including identifying and support opportunities to improve care across different programs. Professionalism Ethical and Confidential Practice: Adherence to legal and ethical standards in health care delivery, maintaining patient confidentiality, and ensuring HIPAA-compliant documentation and communication. Time Management, Organization, and Responsivity: Ability to balance multiple tasks, including managing schedules, and collaborating with the quality team, while maintaining accurate records and staying organized. Ability to manage a task list, and set priorities effectively. Demonstrated ability to manage time effectively while ensuring timely communication and follow-up within and outside the clinical team, the client/family, and their community ensuring continuity of care.

Qualifications:
Master’s or doctoral degree from a behavioral health clinical track (e.g., LCSW, LMHC, LPC, MSW, LMFT, LPC, Ph.D, Psy.D.) Current unrestricted license to practice within the United States 3+ years in behavioral health, quality improvement, or compliance, with experience in chart audits, incident review, and regulatory surveys. Strong understanding of Behavioral Health clinical workflows and documentation requirements, coupled with a high attention to detail and regulatory compliance. Knowledge of performance improvement methodologies (PDSA, Lean, Six Sigma). Data analysis and interpretation skills. Ability to collaborate with multidisciplinary teams and influence practice change.

"We are an Equal Opportunity Employer. We do not discriminate on the basis of race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information or any other category protected by law.
 
By applying for this position, you acknowledge that your personal information will be processed as per the Lyra Health Workforce Privacy Notice. Through this application, to the extent permitted by law, we will collect personal information from you including, but not limited to, your name, email address, gender identity, employment information, and phone number for the purposes of recruiting and assessing suitability, aptitude, skills, qualifications, and interests for employment with Lyra.  We may also collect information about your race, ethnicity, and sexual orientation, which is considered sensitive personal information under the California Privacy Rights Act (CPRA) and special category data under the UK and EU GDPR.  Providing this information is optional and completely voluntary, and if you provide it you consent to Lyra processing it for the purposes as described at the point of collection, for example for diversity and inclusion initiatives.  If you are a California resident and would like to limit how we use this information, please use the Limit the Use of My Sensitive Personal Information form.  This information will only be retained for as long as needed to fulfill the purposes for which it was collected, as described above. Please note that Lyra does not “sell” or “share” personal information as defined by the CPRA. Outside of the United States, for example in the EU, Switzerland and the UK, you may have the right to request access to, or a copy of, your personal information, including in a portable format; request that we delete your information from our systems; object to or restrict processing of your information; or correct inaccurate or outdated personal information in our systems. These rights may be subject to legal limitations. To exercise your data privacy rights outside of the United States, please contact globaldpo@lyrahealth.com. For more information about how we use and retain your information, please see our Workforce Privacy Notice."