Clinical Clearance Specialist (RN)

About the role

The Clinical Clearance Specialist is a fully remote 1099 contractor role within Charlie Health's Clinical Operations / Admissions function. This role serves as the dedicated clinical reviewer for escalated admissions cases involving eating disorder (ED) and substance use disorder (SUD) presentations.

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
• Axess 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