In-Custody Care Quality Review Specialist

Health Right 360; Tolenas (CA); On-site; USD 90,000 - 120,000; Full time

Job summary

HealthRIGHT 360 seeks a Licensed Clinical Review Specialist (LCRP) to conduct clinical reviews of documentation, case notes, assessments, and care plans for jail-based case management, ensuring Medi-Cal billing standards and regulatory compliance. Responsibilities include reviewing Health Risk Assessments, quality assurance, and providing consults to Case Management In-Custody staff.

May provide direct clinical services for complex cases, bridging correctional care with clinical QA and public

Qualifications

• Master’s degree in counseling, social work, or related field.
• Current Behavioral Board of Science (BBS) license (LMFT, LPCC, or LCSW) in California.
• Current First Aid and CPR certification.
• Valid California driver’s license and access to insured transportation.

Responsibilities

• Audit clinical case management notes for accuracy and necessity.
• Review case notes and supporting documentation to ensure compliance with program, regulatory, and billing requirements.
• Verify that all documentation fulfills California Medi‑Cal criteria.
• Enter documentation of services provided in EHR/Provider portal within 24 hours of service delivery.
• Provide feedback to Case Managers to improve documentation quality.
• Monitor case management activities to ensure adherence to Medi‑Cal requirements and organizational standards.
• Collaborate with care management team to establish quality improvement initiatives.

Skills

Clinical QA

Documentation review

Care coordination

Team consultation

Education

Master’s degree in counseling, social work, or related field

Licensed BBS license – LMFT/LPCC/LCSW

First Aid and CPR certification

California driver’s license

Tools

EHR systems

Provider portal

Job description

HealthRIGHT 360 seeks a Licensed Clinical Review Specialist (LCRP) to conduct clinical reviews of documentation, case notes, assessments, and care plans for jail-based case management, ensuring Medi-Cal billing standards and regulatory compliance. Responsibilities include reviewing Health Risk Assessments, quality assurance, and providing consults to Case Management In-Custody staff.

May provide direct clinical services for complex cases, bridging correctional care with clinical QA and public