Clinical Care Reviewer (Remote)

Rula Health, Inc.

Job Overview

Location

Remote - United States

Job Type

Full-time

Full Job Description

📋 Description

• Review clinical documentation, medical records, and outcomes data to assess whether treatment plans meet established medical necessity standards for behavioral health care.
• Synthesize complex clinical information to determine appropriate care trajectories and make evidence-based recommendations for next steps in patient treatment.
• Provide clear, data-driven clinical feedback to providers across Rula’s network to ensure care is clinically appropriate, effective, and aligned with best practices.
• Collaborate cross-functionally with clinical, operations, and technology teams to support quality improvement initiatives and enhance care delivery across the organization.
• Apply expertise in behavioral health treatment planning, progression, and episode duration to evaluate the appropriateness of care intensity and length.
• Ensure compliance with clinical quality benchmarks and regulatory standards through systematic documentation review and audit processes.
• Communicate clinical findings and recommendations with precision to both clinical and non-clinical stakeholders, translating technical details into actionable insights.
• Utilize digital tools including EHR systems, Google Workspace, and Salesforce to efficiently manage documentation reviews and track review outcomes.
• Contribute to scalable clinical workflows by identifying inefficiencies and proposing improvements that enhance accuracy, consistency, and timeliness of care reviews.
• Engage with outcomes measures and utilization trends to inform clinical decision-making and support population-level quality improvement efforts.
• Remain current on evolving behavioral health standards, payer policies, and clinical guidelines to ensure all reviews reflect the most accurate and up-to-date criteria.
• Support the expansion of Rula’s clinical quality infrastructure by participating in pilot programs, process redesigns, and the integration of AI tools to augment review efficiency without compromising clinical rigor.
• Maintain strict confidentiality and adherence to HIPAA and other patient privacy regulations in all documentation handling and communication.
• Contribute to a culture of continuous learning by participating in quarterly wellness events, lunch & learns, and peer feedback sessions focused on clinical excellence.
• Help foster a psychologically safe and inclusive environment by upholding Rula’s values of equity, dignity, and compassion in all interactions with providers and colleagues.
• Participate in company-wide shutdown weeks and utilize paid time off to prioritize personal well-being and prevent burnout.
• Support the onboarding of new clinical staff by sharing best practices in documentation review and care evaluation.
• Maintain accurate records of all clinical reviews, recommendations, and provider feedback in designated digital systems for audit and reporting purposes.
• Advocate for patient-centered care by ensuring all clinical decisions reflect not only compliance but also holistic, compassionate treatment principles.
• Embrace a remote-first work model with flexible hours that support sustainable work-life integration, while maintaining high standards of accountability and responsiveness.

🎯 Requirements

• Master’s degree and active, unencumbered clinical license (LCSW, LMFT, LPC, or equivalent)
• 3+ years of post-licensure experience in behavioral health
• Expertise reviewing clinical documentation and applying medical necessity criteria
• Strong knowledge of behavioral health treatment planning, progression, and appropriate care episode duration
• Excellent written communication and ability to clearly convey clinical findings and recommendations to clinical and non-clinical audiences
• Proficiency working with EHRs and digital tools (e.g., Google Workspace, Salesforce)

🏖️ Benefits

• 100% remote work environment with flexible hours (must be based in United States, currently not hiring in Hawaii)
• Comprehensive health benefits including medical, dental, vision, life, disability, and FSA/HSA
• 401(k) plan access with company contribution
• Generous time-off policies including two company-wide shutdown weeks per year
• Paid parental leave for all types of parents (birthing, non-birthing, adopting, fostering)
• New hire home office stipend and quarterly department stipend for team-building activities

Skills & Technologies

Remote

Degree Required

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Rula Health, Inc.

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About Rula Health, Inc.

Rula Health, Inc. operates an online platform that connects individuals with licensed therapists and psychiatrists for video-based mental health care. The company offers in-network access within the United States, matching patients to providers based on clinical needs, insurance coverage, and scheduling preferences. Services include individual therapy, couples therapy, psychiatry, and medication management. Rula coordinates care through secure telehealth technology, handles insurance billing, and provides ongoing support to both patients and clinicians. Founded in 2021, the company aims to increase access to affordable, evidence-based behavioral health services nationwide.

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