The Clinical Clearance Specialist is a fully remote 1099 contractor role within Charlie Health’s Clinical Operations / Admissions function. This RN serves as the dedicated clinical reviewer for escalated admissions cases involving eating disorder (ED) and substance use disorder (SUD) presentations — cases that require nursing-level clinical expertise beyond the independent decision-making scope of the CAT team, but that do not require physician review.
You will own the clearance review queue, interpret labs, vitals, and EKGs, issue timely admission determinations, and serve as the primary clinical bridge between the admissions team and medical leadership.
Responsibilities
Receive, triage, and independently review escalated clinical clearance requests submitted by the CAT/CAA team
Apply nursing clinical judgment to determine admission appropriateness for complex ED and SUD presentations
Review and interpret ED medical clearance labs (electrolytes, CBC, prealbumin, phosphorous, liver function) and integrate findings into clearance determinations
Evaluate EKG findings relevant to ED presentations — bradycardia, QTc prolongation, ST/T wave changes — in context of nutritional and electrolyte status
Assess orthostatic vital signs and recognize hemodynamic instability
Issue timely clearance outcomes (clear for admission or refer out for HLOC) and communicate directly to CATs
Serve as clinical liaison between the CAT team and medical leadership; prepare organized case summaries for physician-level escalations
Track and follow up on pending lab results; coordinate with clients and providers to eliminate admission delays
Maintain the clinical clearance queue in Salesforce; ensure all ‘Admission Pending — Clinical Clearance’ cases are reviewed promptly
Coordinate MAT-related clearances per state/insurance eligibility criteria; escalate to medical leadership as needed
Identify process gaps and recommend updates to decision trees, templates, and SOPs
Contribute to CAT team training on clinical clearance expectations and escalation criteria
Requirements
Active Registered Nurse (RN) license in good standing; unrestricted licensure required
Minimum 2–3 years of nursing experience; behavioral health, medical-surgical, or eating disorder/SUD-adjacent settings strongly preferred
Working knowledge of ED medical stability criteria: %IBW, percent weight change, BMI thresholds, and refeeding syndrome risk
Ability to review and interpret ED lab panels and identify clinically significant flags: electrolyte abnormalities, CBC deviations, nutritional markers, and liver function
Comfort reviewing EKGs for ED-relevant findings in the context of electrolyte status and nutritional presentation
Working knowledge of SUD presentations including withdrawal risk, MAT, and SUD level-of-care criteria
Strong knowledge of level-of-care frameworks (IOP, PHP, residential, inpatient) and LOCUS criteria
Excellent written communication; ability to document clinical reasoning clearly and concisely
Proficiency with or ability to quickly learn Salesforce or similar CRM/admissions platforms
Familiarity with ASAM criteria preferred; experience in virtual/telehealth behavioral health settings preferred
Bilingual (English/Spanish) a plus
Work authorized in the United States
Compensation & Benefits
This is a 1099 independent contractor role. Hourly compensation is commensurate with experience and credentials.
The total target hourly compensation for this role will be between $48 and $52 per hour at the commencement of engagement. Please note, pay will be determined on an individualized basis and will be impacted by location, experience, expertise, and other relevant business considerations.
Our Values
Connection: Care deeply & inspire hope.
Congruence: Stay curious & heed the evidence.
Commitment: Act with urgency & don’t give up.
Please do not call our public clinical admissions line in regard to this or any other job posting.
Please be cautious of potential recruitment fraud. If you are interested in exploring opportunities at Charlie Health, please go directly to our Careers Page: https://www.charliehealth.com/careers/current-openings. Charlie Health will never ask you to pay a fee or download software as part of the interview process with our company. In addition, Charlie Health will not ask for your personal banking information until you have signed an offer of employment and completed onboarding paperwork that is provided by our People Operations team. All communications with Charlie Health Talent and People Operations professionals will only be sent from @charliehealth.com email addresses. Legitimate emails will never originate from gmail.com, yahoo.com, or other commercial email services.
Recruiting agencies, please do not submit unsolicited referrals for this or any open role. We have a roster of agencies with whom we partner, and we will not pay any fee associated with unsolicited referrals.
At Charlie Health, we value being an Equal Opportunity Employer. We strive to cultivate an environment where individuals can be their authentic selves. Being an Equal Opportunity Employer means every member of our team feels as though they are supported and belong. We value diverse perspectives to help us provide essential mental health and substance use disorder treatments to all young people.
Charlie Health applicants are assessed solely on their qualifications for the role, without regard to disability or need for accommodation.
SPECIALTIES:
Case Management (CM), Triage
