WHY CHARLIE HEALTH? Millions of people across the country are navigating mental health conditions, substance use disorders, and eating disorders, but too often, they’re met with barriers to care. From limited local options and long wait times to treatment that lacks personalization, behavioral healthcare can leave people feeling unseen and unsupported. Charlie Health exists to change that. Our mission is to connect the world to life-saving behavioral health treatment. We deliver personalized, virtual care rooted in connection—between clients and clinicians, care teams, loved ones, and the communities that support them. By focusing on people with complex needs, we’re expanding access to meaningful care and driving better outcomes from the comfort of home. As a rapidly growing organization, we're reaching more communities every day and building a team that’s redefining what behavioral health treatment can look like. If you're ready to use your skills to drive lasting change and help more people access the care they deserve, we’d love to meet you. 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. 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. By clicking "Submit application" below, you agree to Charlie Health's Privacy Policy and Terms of Service. By submitting your application, you agree to receive SMS messages from Charlie Health regarding your application. Message and data rates may apply. Message frequency varies. You can reply STOP to opt out at any time. For help, reply HELP.