About the Role

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.