Clinical Care Reviewer (Remote)

We believe that 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. Rula is a remote-first company. We currently hire in most U.S. states, with the exception of Hawaii. About the Role We are seeking a Clinical Care Reviewer to support Rula’s Clinical Quality team by reviewing clinical documentation and treatment trajectory to ensure care meets medical necessity standards. In this role, you will synthesize clinical documentation, medical record information, and outcomes data to make recommendations on next steps in care and provide data-driven feedback to providers. You will partner cross-functionally to support high-quality, clinically appropriate care across our network. This role is ideal for a licensed clinician who enjoys applying their expertise to improve care at both the individual patient and population level. Required Qualifications • 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) 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 • Experience working with or for health plans or managed care organizations (e.g., Kaiser Permanente) • 1+ years of experience in a high-growth and/or start-up environment • Hands on proficiency working with data (e.g., outcomes measures, utilization trends) to inform clinical decisions • Deep experience with process improvement and building scalable clinical workflows • Comfort using or openness to using AI tools to improve operational efficiency and support clinical review workflows at scale 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): Support for your mental and physical health • New hire home office stipend: Set up your workspace for success • Quarterly department stipend: Fun team-building activities or in-person gatherings • Wellness events and lunch & learns: Explore a variety of engaging topics • Community and employee resource groups: Participate in groups that celebrate employee identity and lived experiences, fostering a sense of community and belonging for all 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. Apply tot his job Apply To this Job