Independent Clinical Reviewer / Hearing Offic at COLLABORATIVE NEUROSCIENCE NETWORK LLC

Colton, California, United States -

Full Time

Start Date

Immediate

Expiry Date

12 Aug, 26

Salary

0.0

Posted On

14 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Necessity Evaluation, Clinical Review, LPS Act Knowledge, Psychiatric Care, Utilization Review, Risk Assessment, Clinical Documentation, Regulatory Compliance, Analytical Thinking, Electronic Health Records, Objective Clinical Judgment, Case Analysis

Industry

Description

VBHC1 – INDEPENDENT CLINICAL REVIEWER (ICR)/HEARING OFFICER Job Title: Independent Clinical Reviewer (ICR) Department: VBHC1 – Adult PHF (72 Beds) Supervisor: Administrative Coordination through Program Leadership Location: Colton, CA Level: Independent Contractor Job Summary The Independent Clinical Reviewer (ICR) provides independent clinical evaluations to determine whether involuntary inpatient psychiatric treatment meets medical necessity criteria and complies with applicable regulatory requirements. This role ensures that care is clinically justified and delivered in the least restrictive setting. The ICR must analyze clinical documentation, treatment plans, and patient progress to determine whether continued inpatient care is appropriate. The role requires the ability to identify inconsistencies, assess risk, and evaluate whether alternative levels of care could safely meet the patient’s needs. The ICR operates independently and must maintain objectivity at all times. Engagement in this role is subject to approval and/or recognition by the San Bernardino County Department of Behavioral Health and applicable oversight entities, as required. Responsibilities and Essential Duties 1. Conduct independent clinical reviews of patient care and treatment. 2. Evaluate medical necessity and continued need for inpatient services. 3. Assess whether treatment is provided in the least restrictive environment. 4. Review documentation for clinical and regulatory compliance. 5. Identify inconsistencies or gaps in clinical justification. 6. Prepare written determinations supporting findings. 7. Maintain independence from clinical staff. 8. Participate in audits or reviews as required. 9. Identify patterns or concerns in clinical practice. 10. Disclose conflicts of interest and recuse from reviews when necessary. 11. Evaluate how clinical findings may affect an individual’s legal detention status under the LPS Act, including alignment with patients’ rights and due process requirements. Minimum Qualifications Education: Master’s or Doctoral degree from an accredited institution in a behavioral health discipline, including psychology, social work, marriage and family therapy, counseling, or a related field required. Medical degree (MD or DO) with specialization in psychiatry is strongly preferred. Experience: Minimum three (3) years of experience in acute psychiatric care or utilization review. Experience within San Bernardino County behavioral health systems is preferred. Specialized Skills · Advanced understanding of medical necessity criteria for inpatient psychiatric care · Knowledge of LPS requirements and least restrictive level of care standards · Ability to independently evaluate treatment plans, progress notes, and risk assessments · Skill in identifying clinical inconsistencies, documentation gaps, and over/under-utilization of services · Strong analytical and critical thinking skills in complex psychiatric cases · Ability to produce clear, defensible clinical determinations aligned with regulatory expectations · Familiarity with DHCS standards and audit expectations · Ability to maintain objective, unbiased clinical judgment independent of treating providers · Proficiency in reviewing electronic health records and clinical documentation systems Physical Requirements Primarily sedentary work involving prolonged sitting, computer use, and review of electronic health records and documentation systems. Licenses/Certifications Active California clinical license required. License must be active, unrestricted, and in good standing with the applicable licensing board. Potential Job Hazards Indirect exposure to high-acuity psychiatric cases and emotionally sensitive subject matter. Safety Precautions Required Adherence to confidentiality standards, secure handling of protected health information, and compliance with all applicable safety and documentation protocols.

Responsibilities

Conduct independent clinical evaluations to determine if involuntary inpatient psychiatric treatment meets medical necessity and regulatory criteria. Prepare written determinations to ensure care is clinically justified and delivered in the least restrictive setting.