Clinical Compliance and Quality Director

About Lavni

Lavni is a Medicaid-first teletherapy platform serving clients across North Carolina, Georgia, and Virginia. We connect underserved communities with diverse, culturally responsive therapists, and we are growing fast, with health-plan partnerships across the Medicaid managed-care ecosystem.

Why this role exists

We have built something most provider organizations do not have: an AI-powered compliance engine that continuously audits every chart against payer documentation standards, scores it, flags gaps, routes fix-it tasks to clinicians with guided workflows, verifies fixes against the live record, and assembles audit-ready records packets on demand. The machine finds the problems. We are hiring the person who owns the outcomes: the clinical judgment, the enforcement, and the number.

What you will own

• The compliance number. Org-wide chart compliance is your KPI. You set remediation quotas, run the review sweeps, and report three numbers to leadership monthly: average chart compliance, correction backlog, and audit-response turnaround.
• QA verification. Clinicians fix and e-sign; you (and the reviewers you direct) verify the fix is real. The platform shows you exactly what changed and when.
• Payer audits and records requests, end to end. Own every records request (they arrive by fax and email into your queue daily) and every payer audit response, on deadline, every time, plan-of-correction authorship included.
• The rulebook. Our audit rules are configurable: when NC Clinical Coverage Policy or an MCO manual changes, you update the engine yourself, no engineering ticket required. You will also calibrate scoring so it reflects true clinical standards.
• Documentation standards and training. Turn recurring findings into micro-training, tracked and e-signed memos, and onboarding standards for new clinicians as the network scales.
• The compliance gate for growth. Documentation and credentialing readiness sign-off as we add therapists and states.

What you have done before

• Active clinical license: LCSW, LCMHC, LPC, or Licensed Psychologist (or RN/HIM with deep behavioral-health documentation experience). NC licensure strongly preferred; GA or VA licensure a plus.
• A plus: a license that can sign NC Medicaid service orders (Licensed Psychologist with a PhD or PsyD, PMHNP, or MD/DO).
• 4+ years in Medicaid behavioral-health QA, utilization review, or compliance. You have lived through payer audits (post-payment review, plan-of-correction cycles) and written the responses.
• Working fluency in NC Medicaid Clinical Coverage Policy (8-series) and MCO documentation standards (Healthy Blue, Partners, Carolina Complete, Trillium, and peers).
• You can defend medical necessity and the golden thread (assessment to treatment plan to note) line by line.
• Dashboard-native: comfortable working queues, reading data, and holding people accountable with evidence.
• Nice to have: CHC or CPCO certification, CABHA-era QA experience, GA/VA Medicaid exposure, experience supervising reviewers.

Why this role is different

Most compliance jobs are archaeology: pulling charts and hoping you sampled the right ones. Here, every chart is already scored when you sit down with your coffee. Your judgment is the scarce resource; we built the machine to make it go further. You will be the clinical conscience of a company that treats compliance as a product, not a binder.

Compensation and logistics

$110,000 to $135,000 depending on experience, plus equity and benefits. Remote-first; NC licensure preferred. Full-time, reports to the Chief Clinical Officer.

Lavni is an equal-opportunity employer. Clinicians of color, LGBTQ+ clinicians, and multilingual candidates are strongly encouraged to apply.

Pay: $110,000.00 - $135,000.00 per year

Application Question(s)

• Have you personally written a response to a payer audit, post-payment review, or plan of correction?
• Have you worked with NC Medicaid Clinical Coverage Policy 8C or an NC LME/MCO (Trillium, Alliance, Partners, or Vaya)?
• Do you hold an active North Carolina license, or can you obtain one within 90 days?

Education

* Doctorate (Preferred)

Experience

* Medicaid behavioral health QA, UR, or compliance: 4 years (Required)

License/Certification

• Licensed Psychologist, PMHNP, or MD/DO (Preferred)
• LCSW, LCMHC, LPC, Licensed Psychologist, or RN (Required)

Work Location: Remote