Clinical Care Reviewer

This position is listed on behalf of a partner company, which manages all applications and next steps. Our partner is looking for a Clinical Care Reviewer based in the United States. The Clinical Care Reviewer will help improve the quality, efficiency, and clinical appropriateness of behavioral healthcare by supporting providers across a nationwide care network. As part of the Clinical Quality team, you will coach clinicians individually, facilitate consultation and educational sessions, and provide clear, timely guidance through written communication. You will also contribute to continued care reviews by evaluating clinical documentation, treatment progress, and appropriate next steps. Your direct engagement with providers will help identify opportunities to refine care processes and improve ongoing clinical initiatives. This role combines clinical expertise, provider education, and quality improvement in a collaborative, remote-first environment. It is an excellent opportunity for a licensed behavioral health professional who enjoys supporting fellow clinicians and making a broader impact on patient care. Accountabilities - Provide one-on-one coaching and guidance to clinicians to support efficient, effective, and clinically appropriate care. - Lead consultation sessions and educational groups focused on clinical practices, treatment planning, and care quality. - Respond to provider questions by email, offering clear, respectful, and actionable guidance. - Support Continued Care Review activities by reviewing clinical records, treatment progress, and documentation to help determine appropriate next steps in care. - Apply clinical documentation standards and medical necessity criteria when reviewing treatment plans and care progression. - Build collaborative relationships with providers and support their understanding of clinical quality expectations. - Gather provider feedback and identify challenges, opportunities, and areas for improvement in care efficiency initiatives. - Share structured observations and recommendations to help refine pilots, programs, and clinical workflows.

- Contribute to initiatives that improve care delivery at both the individual patient and broader population levels. Requirements: - Master's degree in a relevant clinical discipline. - Active, unrestricted clinical license, such as LCSW, LMFT, LPC, or an equivalent credential. - At least 3 years of post-licensure experience in behavioral health. - Experience reviewing clinical documentation and applying medical necessity criteria. - Strong understanding of behavioral health treatment planning, treatment progression, and appropriate episode duration. - Previous experience coaching, training, supervising, or providing feedback to clinicians, including facilitating consultation or educational groups. - Excellent written communication skills, particularly the ability to respond to clinician inquiries clearly, respectfully, and efficiently. - Comfort using electronic health records (EHRs) and digital tools such as Google Workspace and Salesforce. Preferred Qualifications: - Experience in utilization management, peer review, or clinical quality. - Familiarity with health plans, managed care organizations, or value-based care programs. - At least 1 year of experience in a high-growth startup environment. - Experience with measurement-informed care and using data, including outcome measures and utilization trends, to guide clinical decisions and provider coaching. - Experience implementing new programs, pilots, or initiatives in evolving environments and providing structured feedback for continuous improvement. - Experience using AI tools, or openness to adopting them, to improve clinical review and provider communication workflows. - Availability aligned with Mountain Standard Time (MST) or Pacific Standard Time (PST) is preferred.