Director of Clinical Quality

Cartwheel is an early-stage company building a new kind of mental health program for kids that puts schools at the center. We see our role as supporting school staff who see kids every single day. Instead of going around them, we collaborate with them. This means: 

• Earlier intervention
• Higher student and family engagement in care
• Better coordination among the trusted adults in a student’s life 

Kids shouldn't just aspire to get out of bed and drag themselves to class. They should be able to experience joy. They deserve to envision and build a life they’re excited to live. If you join Cartwheel, you’ll help make this vision a reality for millions of students across the country. We’re backed by top investors including A Street Ventures, Menlo Ventures, Reach Capital, General Catalyst, BoxGroup, and Able Partners, and we're looking for mission-driven teammates to join our team.

The Director of Clinical Quality owns the strategic design, implementation, and ongoing maturation of Cartwheel's quality and compliance function. This is a builder role for someone who has done it before — with 5+ years of direct experience creating clinical quality infrastructure from the ground up in scaling behavioral health environments, not inheriting or maintaining existing systems.

This role sets the standard for what high-quality, compliant care looks like across a distributed, multi-state telehealth network — and then builds the systems, frameworks, and partnerships to make that standard real and measurable. The Director operates with significant autonomy, exercises independent judgment on complex regulatory and clinical risk questions, and influences clinical and operational strategy at the leadership level.

Role type: W2, Full-Time, Salaried position
Salary range: $155,000 - 185,000 cash compensation plus competitive equity package
Location: Remote
Start date: Summer 2026

• Quality Strategy and Infrastructure: Own clinical quality strategy for a rapidly scaling network spanning 20+ states, 400+ clinicians, and multiple care models. Design and operationalize frameworks for performance monitoring, documentation standards, and audit readiness that are built to scale — not patched as the organization grows. Translate regulatory requirements into practical workflows. Present quality trends, risk signals, and improvement recommendations to the extended leadership team alongside peers in Clinical, Operations, and Product. Inform board-level reporting on clinical risk and compliance posture.
• Clinical Supervision Standards: Define what effective, evidenced based clinical supervision looks like at Cartwheel and build the systems to measure and develop it. Supervision quality integrates into the broader clinical scorecard and informs how Cartwheel represents its clinical model to payers and partners.
• Compliance and Regulatory Risk: Own HIPAA compliance, incident management, complaint and grievance workflows, and payer audit readiness across all operating jurisdictions. Build clinical compliance policy infrastructure that anticipates growth rather than reacts to it. Represent Cartwheel's compliance posture in payer and partner conversations.
• Provider Performance and Network Standards: Set the performance standard for Cartwheel's clinician network — not just identify when it's missed. Partner with Clinical Managers and Provider Network Operations to design re-education pathways and escalation criteria that work within a 1099 model. Use trend data to drive upstream changes in onboarding, training, and network composition.
• Organizational Quality Leadership: Lead and develop a team that grows with the organization. Shape how quality is understood and practiced across clinical, operations, product, school-facing, and support functions — not just within the clinical team. Partners across the organization should feel the influence of this role in how they design workflows, build product features, and make decisions that touch care quality. Serve as the internal authority consulted early on high-stakes decisions, translating standards into clarity that empowers rather than polices.

• 5+ years building clinical quality infrastructure in behavioral health — not inheriting or maintaining, but creating
• Designed clinical supervision competency frameworks in distributed or multi-site settings
• Deep working knowledge of HIPAA, multi-state telehealth regulations, and behavioral health licensing requirements across a large, active state footprint
• Experience owning external regulatory relationships — payers, auditors, or state agencies
• Clinical licensure (LCSW, LPC, or equivalent) strongly preferred
• Approaches quality infrastructure with an innovation and automation mindset — actively leverages AI and technology to build monitoring, reporting, and compliance systems that scale without scaling headcount
• Operates at the strategic level: you see where quality risks are heading before they arrive and position the organization accordingly can you do market research to answer her question
• Familiarity with Joint Commission/CARF accreditation processes – ideally direct experience leading or contributing to an accreditation effort in a behavioral health or telehealth environment

Please apply even if you don't meet all of the criteria. If your past experience doesn't perfectly match the job description, but you bring other relevant experience or skills, we'd still love to hear from you. You may be a great fit!

Our hope is that Cartwheel will be your best career decision! In addition to tackling one of the biggest challenges of our time, at a company well-positioned to do so, you'll have:

• Mission-oriented and inclusive colleagues who will go to bat for you
• Competitive compensation
• Generous PPO medical, vision, and dental/ortho coverage
• Life Insurance
• Generous paid time off, including company closure from Christmas-New Years (12/25-1/1)
• Paid holidays and sick leave
• Paid parental leave
• 401K with employer match
• Meaningful equity ownership stake in Cartwheel
• Flexible and remote role with regular in-person retreats
• Annual learning stipend
• Laptop