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Clinical Care Reviewer

🔥 11 hours ago
Behavioral HealthClinical Documentation ReviewMedical Necessity CriteriaTreatment Planning
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📜 Description

  • Coach providers 1:1 to support efficient, effective, and clinically appropriate care.
  • Lead consultation and education groups and respond to provider questions by email.
  • Review charts and treatment progress for Continued Care Review work as needed.
  • Share provider experience observations to help refine care efficiency pilots.

🛠️ Requirements

  • Master’s degree and active, unencumbered clinical license (LCSW, LMFT, LPC, or equivalent) and 3+ years of post-licensure experience in behavioral health
  • Experience reviewing clinical documentation and applying medical necessity criteria, with a strong understanding of behavioral health treatment planning, progression, and appropriate episode duration
  • Experience coaching, training, supervising, or giving feedback to clinicians, including facilitating consultation or education groups
  • Excellent written communication, including the ability to respond to clinician emails clearly, respectfully, and efficiently
  • Comfort working with EHRs and digital tools (e.g., Google Workspace, Salesforce)
  • Experience in utilization management, peer review, or clinical quality roles
  • Familiarity working with or for health plans, managed care organizations, or value-based care programs (e.g., Kaiser Permanente)
  • 1+ year experience in high growth startup environment
  • Experience with measurement-informed care and comfort working with data (e.g., outcome measures, utilization trends) to inform clinical decisions and provider coaching
  • Experience carrying out new programs, pilots, or initiatives in an evolving environment, and sharing structured feedback to improve them

✨ Benefits

  • Transparent pay ranges.
  • Medical insurance
  • Dental insurance
  • Vision insurance
  • Life and disability benefits
  • FSA/HSA
  • 401(k) plan access
  • Generous time off, including two company-wide shutdown weeks each year for most employees
Full job description

At Rula, we are a remote-first company that believes mental health is just as important as physical health. We recognize that mental health issues can be complex and multifaceted, and we are dedicated to treating the whole person, not just the symptoms.

We aim to create a world where mental health is no longer stigmatized or marginalized, but rather is embraced as an integral part of one's overall well-being. 

We believe that by providing quality care that is both evidence-based and compassionate, we can empower individuals to take charge of their mental health and achieve their full potential. We are passionate about making a positive impact on the lives of those struggling with mental health issues and we strive to be a force for positive change in the field of mental healthcare.

About the Role

We’re seeking a Clinical Care Reviewer to help bring Rula’s care efficiency pilots to life as part of our Clinical Quality team. In this role, you’ll work directly with providers across our network, coaching them 1:1, leading consultation and education groups, and responding to their questions by email, to support efficient, effective, and clinically appropriate care. You’ll also support Continued Care Review work as needed, reviewing charts and treatment progress to guide next steps in care. Because you’re closest to the provider experience, your observations about what’s working and what isn’t will directly shape how Rula’s pilots are refined. This role is ideal for a licensed clinician who enjoys working with other clinicians, communicates clearly in writing, and wants to help improve care at both the individual and population level.

Required Qualifications

  • Master’s degree and active, unencumbered clinical license (LCSW, LMFT, LPC, or equivalent) and 3+ years of post-licensure experience in behavioral health

  • Experience reviewing clinical documentation and applying medical necessity criteria, with a strong understanding of behavioral health treatment planning, progression, and appropriate episode duration

  • Experience coaching, training, supervising, or giving feedback to clinicians, including facilitating consultation or education groups

  • Excellent written communication, including the ability to respond to clinician emails clearly, respectfully, and efficiently

  • Comfort working with EHRs and digital tools (e.g., Google Workspace, Salesforce)

Preferred Qualifications

While having the preferred qualifications enhances your candidacy, having all of them is not mandatory. We encourage all interested applicants to apply, even those who may not meet every preferred requirement.

  • Experience in utilization management, peer review, or clinical quality roles

  • Familiarity working with or for health plans, managed care organizations, or value-based care programs (e.g., Kaiser Permanente)

  • 1+ year experience in high growth startup environment

  • Experience with measurement-informed care and comfort working with data (e.g., outcome measures, utilization trends) to inform clinical decisions and provider coaching

  • Experience carrying out new programs, pilots, or initiatives in an evolving environment, and sharing structured feedback to improve them

  • Experience using, or openness to using, AI tools to improve efficiency and support clinical review and provider communication workflows

  • MST and PST timezones are preferred

We're serious about your well-being! As part of our team, full-time employees receive:

  • 100% remote work environment: Working hours to support a healthy work-life balance, ensuring you can meet both professional and personal commitments (must be based in United States, currently not hiring in Hawaii)

  • Attractive pay and benefits: Full transparency of pay ranges regardless of where you live in the United States

  • Comprehensive health benefits: Medical, dental, vision, life, disability, and FSA/HSA

  • 401(k) plan access: Start saving for your future

  • Generous time-off policies: Including 2 company-wide shutdown weeks each year for self-care (for most employees)

  • Paid parental leave: Available for all parents, including birthing, non-birthing, adopting, and fostering

  • Employee Assistance Program (EAP): Supporting your mental and physical health

  • Quarterly department stipend: Fun team-building activities or in-person gatherings

  • Community and employee resource groups: Participate in groups that celebrate employee identity and lived experiences, fostering a sense of community and belonging for all

  • Home office stipend: New hire home office stipend & $50 monthly stipend to help cover internet or cell phone expenses

  • Wellness at Rula program: Year-round wellness initiatives and a $50/month wellness stipend

Our team

We believe that diversity, equity, and inclusion are fundamental to our mission of making mental healthcare work for everyone.  We are dedicated to having a culture of inclusion that will support our employees in feeling safe, seen, heard, and valued.

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