Market Clinical Services Director

Market Clinical Services Director - Massachusetts

Massachusetts (Greater Boston) | Full-Time Hybrid

ANNA (Allied Network for Neurodevelopmental Advancement), is a mission-driven organization that provides ABA services to young autistic children (under the age of 6) and their families using a neurodiversity-affirming, Naturalistic Developmental Behavioral Intervention (NDBI approach). We have multiple centers (5 and growing!) in Massachusetts and are looking for a passionate, experienced clinical leader to help elevate and expand the quality of care our growing team delivers.

The Market Clinical Services Director (MCSD) for Massachusetts serves as the senior clinical leader for ANNA's Massachusetts market. Together with the Market Executive Director, the MCSD forms the market leadership dyad and is jointly accountable for the performance of the market, including clinical quality, team and family satisfaction, and financial sustainability. Reporting to the Chief Clinical Officer, the MCSD is individually responsible and accountable for the quality of clinical services across the state, the professional development of clinicians in the market, and the expansion of ANNA's clinical presence in Massachusetts. Clinical Directors across the market report on a solid line to the Market Executive Director and on a dotted line to the MCSD for clinical quality, model fidelity, treatment planning, case review, and clinical development. The MCSD holds clinical decision-making authority within standards established by the Chief Clinical Officer, while the Market Executive Director retains responsibility for operational execution and people management. The MCSD leads through expertise, mentorship, and consistent presence, serving as the clinical subject matter expert for Clinical Directors, BCBAs, Behavior Analyst Trainees (BATs), and Behavior Technicians across every Massachusetts center.

Success in this role will be measured by fidelity to ANNA's NDBI-based clinical model, clinician skill progression and retention, client clinical outcomes, family satisfaction with care, and the strength of ANNA's clinical reputation with payers, referral partners, and the academic community across Massachusetts.

Compensation & Benefits

• Base salary: $150,000-$170,000

• Bonus potential

• Benefits:

401(k) with company match

Health, dental, and vision insurance

Generous PTO and paid holidays

Support for professional development, including certification maintenance and conference attendance

What You'll Do

Clinical Quality and Model Fidelity

· Own clinical quality across all Massachusetts centers, ensuring services delivered reflect ANNA's neurodiversity-affirming, NDBI-based model of care

• Oversee fidelity monitoring, documentation, reporting, and quality improvement at the state level with support from the Chief Clinical Officer

• Ensure the fidelity assessment tools, scoring methodologies, and evaluation protocols developed centrally are consistently and correctly used by Massachusetts clinical teams

• Ensure state alignment with ANNA's treatment planning templates, clinical documentation standards, and case review processes

• Provide consultation on complex clinical cases, program design questions, and advanced clinical decision-making for clinicians across the market, escalating to the Chief Clinical Officer where organizational precedent is required

• Aggregate and funnel clinical feedback from Massachusetts teams to the Chief Clinical Officer and central clinical team to drive improvement of ANNA's standards, protocols, and tools

Clinical Training and Professional Development

• Train Behavior Analyst Trainees (BATs) to deliver Behavior Technician onboarding training with fidelity, ensuring every BAT is assessed and passes competency before independently onboarding new BTs

• Participate in training new Clinical Directors on all clinical components of client and team training, support, and oversight

• Monitor BAT training implementation by completing training fidelity checks at minimum monthly across the market, and provide direct coaching and remediation where fidelity falls below standard

• Train Clinical Directors to supervise and oversee the BATs in their centers, ensuring every Clinical Director is assessed and passes competency on observing BAT-delivered training, evaluating fidelity, delivering performance feedback, and escalating concerns

• Hold ongoing oversight of how Clinical Directors carry out BAT supervision across the market, ensuring the supervision layer between CD and BAT is consistent and effective in every center

• Train and support Clinical Directors in delivering BCBA and BAT training, and monitor training execution across all Massachusetts centers

• Ensure ANNA's expectations for clinical supervision, mentorship, and skills progression are met across every clinical role in the market

• Update centrally developed training materials to reflect Massachusetts-specific requirements, following approval by the Chief Clinical Officer

• Provide structured feedback to the Chief Clinical Officer on training curricula, materials, and delivery based on how they perform in the market

• Execute ANNA's clinical professional development plan in Massachusetts, including supervision structures for BCBA candidates, continuing education programming, and skills progression planning for clinicians at every level

Clinical Leadership and Mentorship

• Hold dotted-line clinical oversight of every Clinical Director in the market, setting and upholding the clinical bar for their centers, while the Market Executive Director holds solid-line accountability for their operational and people management

• Provide hands-on mentorship and clinical support to the state's Clinical Directors and BCBA team

• Hold weekly 30-minute Clinical Support 1:1s with each Clinical Director, covering clinical quality and fidelity, treatment plan and programming review, and case discussion

• Lead the bi-weekly Market Clinical Meeting with Clinical Directors as the forum for clinical questions, rollouts, updates, and process changes

• Co-lead the monthly Market All-BCBA Meeting with the Market Executive Director, covering initiative rollouts, training, and key clinical topics relevant to the market

• Provide clinical input into Clinical Director hiring and BCBA hiring decisions led by the Market Executive Director

• Contribute clinical perspective to promotion recommendations, calibration meetings, and performance discussions for clinical staff, in partnership with the Market Executive Director and Clinical Directors

• Build a market culture of clinical curiosity, ethical practice, and continuous improvement through regular presence in centers

Clinical Authority and Decision-Making

• Hold decision-making authority for implementation of ANNA’s clinical standards across Massachusetts, including model fidelity, treatment quality, clinical competency, and required remediation, within standards established by the Chief Clinical Officer

• Require and oversee clinical corrective action plans when quality, fidelity, or competency falls below established standards, partnering with the Market Executive Director to secure resources and ensure timely completion

• Determine clinical leaders' readiness for staff to independently perform designated clinical, training, and supervision responsibilities, including requiring additional coaching or reassessment before competency approval

• Provide required clinical sign-off on Clinical Director hiring and promotion decisions, in partnership with the Market Executive Director, who retains responsibility for operational and people management decisions

• Initiate immediate protective action when a practice presents a significant risk to client safety or ethical care, including pausing the affected activity and promptly escalating to the Chief Clinical Officer

• Escalate unresolved clinical and operational disagreements to the Chief Clinical Officer and Chief Operations Officer, with the Chief Clinical Officer holding final authority on clinical standards and patient-care safeguards

Market Partnership and Clinical Operations

• Partner with the Market Executive Director as the market leadership dyad, meeting at minimum weekly to align on market priorities, clinical quality, staffing, and performance

• Co-lead the bi-weekly Market Performance Update and the Monthly Business Review with the Market Executive Director for the Chief Clinical Officer, Chief Operations Officer, and CEO

• Attend Weekly Clinic Health Meetings led by Clinical Directors, contributing clinical problem-solving on authorization escalations, protocol modification, parent training, caseload balancing, and team performance

• Partner with the Market Executive Director on market-level payer relationship management, contributing clinical expertise to contract discussions, payer inquiries, and audit responses in coordination with the Revenue Cycle team

• Support and provide additional guidance on client service request denials and appeals, including clinical justification, medical necessity documentation, and peer-to-peer reviews

• Consult with Clinical Directors on caseload composition and load balancing across pods to protect clinical quality, clinician development, and client outcomes

• Support market readiness for new center openings by ensuring clinical staffing, training, supervision structures, and model fidelity are in place ahead of launch

External Engagement, Research, and Outcomes

• Expand ANNA's clinical presence in Massachusetts through relationships with universities, academic training programs, professional associations, and clinical community partners

• Collaborate with the Chief Clinical Officer and Clinical Directors on state-level research projects

• Collaborate with the Chief Clinical Officer on state-level community, academic, and research partnerships

• Attend and present at regional and national conferences, representing ANNA's clinical model, outcomes, and approach to care

• Support the community outreach and engagement team with university relationships, practicum and internship pipelines, and clinical presentations to referral sources

Clinical Compliance and Ethical Practice

• Ensure Massachusetts clinical practice aligns with BACB ethical standards, state licensure requirements, payer clinical criteria, and accreditation standards including ACQ

• Partner with the Chief Clinical Officer to ensure ANNA's clinical standards reflect current regulatory, accreditation, and payer requirements specific to Massachusetts

• Support the Market Executive Director on clinically significant incidents, contributing clinical review, root cause analysis, and clinical corrective action

• Support Massachusetts clinical readiness for accreditation reviews, payer audits, and regulatory review, including documentation review and clinician preparation

• Escalate clinical risk, ethical concerns, and practice deviations to the Chief Clinical Officer

Qualifications

Required

• Master's degree in Applied Behavior Analysis, Psychology, Special Education, or a closely related field

• Board Certified Behavior Analyst (BCBA) in good standing

• Licensed Applied Behavior Analyst (LABA) in Massachusetts, or license-eligible and able to obtain licensure prior to start

• 8+ years of clinical experience in ABA, including 5+ years as a BCBA and 3+ years in a clinical leadership role at the Clinical Director level or above

• Demonstrated experience training and supervising BCBAs, supervisees, trainees, and behavior technicians, including training others to train

• Deep expertise in Naturalistic Developmental Behavioral Intervention approaches and early intervention for children under 6

• Demonstrated experience building or operating clinical quality and fidelity systems

• Proven ability to lead, influence, and drive change through dotted-line relationships rather than direct reporting authority

• Strong clinical judgment, written communication, and coaching skills

• Willingness to travel regularly to centers across Massachusetts

Preferred

• Doctoral degree and/or BCBA-D

• Experience in a multi-site or multi-state behavioral health organization

• Experience with accreditation processes, including the Autism Commission on Quality (ACQ)

• Familiarity with Massachusetts payer clinical criteria and appeals processes, including MassHealth, Carelon, Tufts, BCBS MA, and Optum

• Peer-reviewed publication, conference presentation history, or academic affiliation

• Experience in a high-growth or start-up environment

Ideal Candidate

You are a clinician-leader who believes quality is built through people, not policed through checklists. You are equally comfortable reviewing a treatment plan, coaching a first-year BCBA through a difficult case, and presenting your market's outcomes to an executive team. You lead through credibility rather than authority, and you are energized by the challenge of holding a high clinical bar across multiple centers while the organization grows around you. You are deeply committed to neurodiversity-affirming, assent-based practice, and you can translate that commitment into concrete standards, training, and supervision that clinicians can actually use. You partner naturally with operational leaders, understanding that strong clinical care and a sustainable business are not in tension.

Why ANNA?

At ANNA, we are working to transform autism care by combining rigorous clinical training, compassionate family-centered practice, and neurodiversity-affirming approaches. Our Naturalistic Developmental Behavioral Intervention (NDBI) model supports each child's strengths through play-based, developmentally informed care.

As the Market Clinical Services Director, you will own the clinical standard of care for an entire state, shaping how our model is delivered, how our clinicians grow, and how ANNA is known within the Massachusetts clinical and academic community.

You can learn more about us here: https://annaautismcare.com/about-us/

Location: Two to three days per week onsite across Massachusetts centers, with remaining work performed remotely or in the community and additional onsite presence during openings or significant clinical needs

ANNA is an equal opportunity employer. We're committed to creating a diverse, inclusive, and supportive workplace. All qualified applicants receive consideration for employment without regard to race, color, national origin, age, disability, religion, sex (including pregnancy, sexual orientation, and gender identity), or any other characteristic protected by law. If you're passionate about our mission but don't meet every qualification listed, we still encourage you to apply. Your unique perspective might be exactly what we need.