Clinical Care Reviewer
New
R
RulaMental healthcare
We currently hire in most U.S. states, with the exception of Hawaii.Full-TimeMiddle
Salary90,015 - 100,605 USD per year
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Job Details
- Experience
- 3+ years of post-licensure experience in behavioral health
- Required Skills
- Data AnalysisSalesforceGoogle WorkspaceEHR
Requirements
- Master’s degree
- Active, unencumbered clinical license (LCSW, LMFT, LPC, or equivalent)
- 3+ years of post-licensure experience in behavioral health
- Expertise in reviewing clinical documentation
- Application of medical necessity criteria
- Knowledge of behavioral health treatment planning
- Excellent written communication skills
- Proficiency with EHRs
- Proficiency with Google Workspace and Salesforce
Responsibilities
- Review clinical documentation and treatment trajectory for medical necessity
- Synthesize medical records and outcomes data for care recommendations
- Provide data-driven clinical feedback to providers
- Partner cross-functionally to support clinical quality
- Improve care at individual patient and population levels
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