Community HealthWorks
Location
Sacramento, California
Salary
$55 - $75 / HOUR
The Licensed Clinical Reviewer performs quality assurance and clinical documentation reviews for CalAIM programming to ensure alignment with billing standards and program requirements. This role involves providing feedback to staff, determining client acuity, and supporting audit readiness.
Candidates must hold an active California license as an LCSW or RN and have experience with Medi-Cal populations or managed care. Experience with Enhanced Care Management (ECM) and Community Supports is preferred.
Please submit a resume and cover letter. Your resume will not be considered if a cover letter is not included.
About Community HealthWorks Community HealthWorks (CoHeWo) is committed to advancing health equity and improving access to care for underserved communities. We partner with managed care plans, health systems, community-based organizations, and government agencies to ensure individuals and families can access the coverage, services, and resources they need to thrive.
Under the direction of the Associate Director, the Licensed Clinical Reviewer supports clinical documentation review and quality assurance for CalAIM programming within Community HealthWorks. This role focuses on reviewing documentation to ensure alignment with program requirements, billing standards, and organizational expectations.
This is a per diem, non-exempt (hourly) position with no guaranteed hours. Work will be assigned based on program needs. This position does not provide direct client care or serve as a primary clinical supervisor. While the role does not include routine direct client care, there may be occasional opportunities to support program staff with clinical guidance or client interaction, as appropriate.
What We’re Looking For Education & Experience Active California license in one of the following: Licensed Clinical Social Worker (LCSW), or Registered Nurse (RN) Experience working with Medi-Cal populations, managed care, or community-based services Experience with Enhanced Care Management (ECM) and/or Community Supports preferred Experience reviewing or documenting clinical or service-related activities Skills & Attributes Strong attention to detail and ability to review documentation thoroughly and accurately Ability to apply judgment in assessing documentation and identifying gaps Clear and effective communication skills Ability to work independently and manage assigned workload within established timelines Commitment to serving underserved populations with cultural humility and respect
Successful completion of a criminal background check Compliance with immunization and safety requirements, including COVID-19 policies as applicable Work Schedule & Environment Per diem, hourly role with no guaranteed hours Work assigned based on program needs Typical workload may range from 0–10 hours per week Remote or hybrid work environment depending on organizational needs
Please submit your application through our Paylocity portal, including: Resume Cover letter Completed application and supplemental questions
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