Care Review Clinician II | Remote | Contract

Walker Healthforce; Long Beach (CA); Remote; USD 55,000 - 83,000; Full time

Benefits offered by this job

Weekly pay via Direct Deposit

Medical, Dental & Vision

401k options

Job summary

Walker Healthforce, Inc. is seeking a Care Review Clinician II with 2-4 years of clinical practice to perform inpatient and outpatient behavioral health utilization reviews and support medical necessity decisions.

This is a remote contract role. In this position, you will review cases, complete concurrent reviews and prior authorizations, and collaborate with providers, medical directors, and interdisciplinary care teams while maintaining compliant records.

Qualifications

• Minimum 2-4 years of clinical practice in behavioral health reviews.
• Experience with inpatient and outpatient behavioral health utilization management.
• Active, unrestricted RN, LVN or LPN license in good standing.
• Completion of an accredited Registered Nursing program or equivalent experience.
• Knowledge of InterQual, medical necessity and length-of-stay criteria; NCQA regulations.

Responsibilities

• Review behavioral health cases for inpatient and outpatient utilization management.
• Complete concurrent reviews and prior authorizations, assessing eligibility and benefits.
• Collaborate with providers, medical directors and interdisciplinary care teams.
• Meet quality and productivity expectations and maintain compliant, confidential records.
• Support team meetings and mentoring on projects.

Skills

Nursing license

InterQual knowledge

Medical necessity criteria

MS Office

Communication

Organization

Length of stay criteria

Education

Registered Nursing program completion

Job description

Care Review Clinician II | Remote | Contract
Business & Care Management Long Beach , California Contract Nov 6, 2026

Walker Healthforce is seeking a Care Review Clinician II with 2-4 years of clinical practice to conduct inpatient and outpatient behavioral health utilization reviews and support medical necessity decisions. This is a Contract opportunity.

Start Date: ASAP

Location: Remote

Approved Work Locations: AZ, FL, GA, ID, IA, KY, MI, MS, NE, NM, NY (outside greater-NYC), OH, SC, TX, UT, WA (outside greater-Seattle), WI

Worker Type: W2

Core Requirements:

• Minimum 2-4 years of clinical practice and prior inpatient and outpatient behavioral health/psychiatric reviews.
• Behavioral health utilization management experience across inpatient and outpatient services.
• Active, unrestricted RN, LVN or LPN state nursing license in good standing.
• Completion of an accredited Registered Nursing program (combination of education and experience considered in lieu of degree).
• Knowledge of InterQual, medical necessity and length-of-stay criteria, NCQA and applicable regulations; strong communication, organization and Microsoft Office skills.

We Consider It A Bonus If You Also Have:

• Hospital nursing, utilization management and/or case management background.

Prior PEGA experience.

Job Responsibilities:

• Review behavioral health/psychiatric cases for inpatient and outpatient utilization management.
• Complete concurrent reviews and prior authorizations, assessing eligibility, benefits and anticipated length of stay.
• Collaborate with providers, medical directors and interdisciplinary care teams.
• Meet quality and productivity expectations and maintain compliant, confidential records.
• Support team meetings, mentoring and assigned projects.

What We Offer:

• Competitive compensation package
• Weekly pay via Direct Deposit
• Medical, Dental & Vision available
• 401k options

Why Work With Walker?

• Access to our top ranked team of recruiting and placement specialists
• Continuous, one-on-one support from a dedicated engagement manager
• Professional resume development and interview preparation

About Us

Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we're custom not commodity and we've been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!

We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment.