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Therapy Clinical Reviewer Jobs (NOW HIRING)

Comagine

Clinical Reviewer

Master's in physical or occupational therapy OR Master's in psychology, counseling, or social work ... Clinical documentation review expertise, including use of the Oregon Health Plan Prioritized List ...

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Therapy Clinical Reviewer information

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$34

$90

How much do therapy clinical reviewer jobs pay per hour?

As of Jul 29, 2026, the average hourly pay for therapy clinical reviewer in the United States is $34.62, according to ZipRecruiter salary data. Most workers in this role earn between $16.59 and $32.93 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Therapy Clinical Reviewer, and why are they important?

To thrive as a Therapy Clinical Reviewer, you need a solid background in behavioral health or therapy, typically supported by a relevant clinical license (e.g., LCSW, LPC, or LMFT) and experience in direct patient care. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of insurance or regulatory guidelines are commonly required. Strong analytical skills, attention to detail, and effective communication are essential soft skills for evaluating clinical documentation and collaborating with providers. These skills and qualifications ensure accurate clinical reviews, regulatory compliance, and optimal patient outcomes.

What Is the Job of a Therapy Clinical Reviewer?

As a therapy clinical reviewer, your job is to review each case and determine whether or not a proposed care plan is appropriate for the patient. In this role, you may gather and document information about the patient and their case, review their eligibility for insurance benefits, and make the final decision about whether a particular service or treatment should be used. A therapy clinical reviewer often specializes in specific areas, such as physical therapy or speech therapy, and may focus on unusual or expensive cases that require extra attention during the auditing process. You may also coach letter writers to ensure that the appropriate medical necessity language is used in denial letters.

What are the primary responsibilities of a Therapy Clinical Reviewer and how do they interact with other healthcare professionals?

A Therapy Clinical Reviewer is responsible for evaluating therapy-related clinical documentation to determine the medical necessity and appropriateness of proposed treatments. This role often involves reviewing patient records, treatment plans, and progress notes submitted by therapists, and making recommendations or decisions regarding coverage or further care. Therapy Clinical Reviewers frequently collaborate with therapists, physicians, and case managers to clarify clinical details and ensure adherence to policy guidelines. Effective communication and teamwork are essential, as the reviewer must translate clinical findings into actionable feedback and sometimes participate in multidisciplinary case discussions.

What is a Therapy Clinical Reviewer?

A Therapy Clinical Reviewer is a licensed health professional, such as a physical therapist, occupational therapist, or speech-language pathologist, who evaluates clinical documentation and treatment plans to determine the medical necessity and appropriateness of therapy services. They typically work for insurance companies, healthcare organizations, or third-party review agencies, and ensure that therapy services provided to patients meet established guidelines and standards of care. Their work helps promote quality patient care while managing healthcare costs and complying with regulations.
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Therapy Clinical Reviewer jobs near you
Infographic showing various Therapy Clinical Reviewer job openings in the United States as of July 2026, with employment types broken down into 2% As Needed, 73% Full Time, 17% Part Time, and 8% Contract. Highlights an 95% Physical, 1% Hybrid, and 4% Remote job distribution, with an average salary of $72,002 per year, or $34.6 per hour.

Clinical Reviewer

Comagine

Remote

Other

Medical, Dental, Vision, Retirement, PTO

Posted 6 days ago

Job description

Behavioral Health Services Reviewer

Are you passionate about improving access to behavioral health services in the community? Do you enjoy using your clinical expertise to evaluate needs, support care decisions, and help individuals receive the right services at the right time?

In this role, you will review clinical documentation to determine medical necessity and appropriateness of services, complete functional needs assessments that evaluate how mental health symptoms impact daily living, and support service coordination that connects children, youth, and adults to in-home and community-based care. You will manage referrals, follow-ups, reviews, and assessments within an electronic medical record system; apply evidence-based criteria to utilization management reviews; document clinical determinations; provide subject matter expertise to stakeholders; support quality activities and audits; and travel for in-person assessments as needed across your assigned region.

If you are someone who demonstrates strong clinical judgment, builds trusting relationships with members and partners, and effectively manages a high-volume workload while meeting timelines, we encourage you to apply. If you bring a collaborative mindset, accountability in your work, curiosity to ask questions and learn, and comfort using technology to navigate systems and documentation, you will be well-positioned for success on this team. This is a remote position based in Oregon and travel is required.

Why Comagine Health?

Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years.

We are leaders in assisting front-line providers and engaging health care partners to improve care delivery and patient outcomes.

Our talented remote workforce spans the country and plays a vital role in our success. We go beyond merely providing a remote work option; we support and embrace it. We offer opportunities to make a difference from anywhere in the U.S. and enjoy better work-life balance. An annual stipend gives you the freedom to enhance your workspace with options that suit your needs.

We believe in an environment that allows you to thrive both personally and professionally. That's why we offer benefits that include:

  • Medical, dental and vision insurance
  • Paid time off for vacation, illness, and volunteering
  • Retirement savings plan with employer contribution
  • Adoption financial assistance
  • Paid parental leave.
  • And much more!

You Have (Required Qualifications)

  • Current, active, unrestricted clinical licensure as required by the Oregon contract (e.g., RN or behavioral health licensure such as LCSW, LPC, LCPC, LPA, PsyD, PhD)
  • Master's in physical or occupational therapy OR Master's in psychology, counseling, or social work OR Bachelor's degree in nursing and licensed by the State of Oregon
  • 3 years of clinical (direct patient care) experience; behavioral health preferred

Candidates must reside in Oregon, have personal transportation, and ability to travel. Valid Driver License and Proof of Auto Insurance are required.

You May Have (Desired Qualifications)

  • Experience with Medicaid
  • Knowledge of the Oregon behavioral health system of care
  • 2 years of utilization review or other medical management experience
  • 2 years of full-time substance use disorder and/or behavioral health disorder experience

You Bring (Competencies)

  • Clinical documentation review expertise, including use of the Oregon Health Plan Prioritized List of Health Services and InterQual
  • Strong organizational skills and ability to manage multiple tasks in a team environment
  • Excellent oral and written communication skills
  • Strong interpersonal and problem-solving skills
  • Proficiency with MS Office Suite and familiarity with database software
  • Ability to apply clinical review criteria, policies, and guidelines to determine medical necessity
  • Ability to document utilization review determinations accurately and timely in designated systems
  • Capability to provide clinical and utilization review subject matter expertise and respond to stakeholder questions or concerns

In this Role, You Will

  • Review clinical documentation to substantiate medical necessity and appropriateness for requested services
  • Perform initial and continued stay reviews using standardized, evidence-based criteria to ensure services align with individualized behavioral health needs
  • Apply clinical review criteria, organizational policies, guidelines, and screening tools to determine medical necessity of healthcare services
  • Document utilization review determinations accurately and timely in designated systems
  • Consult with physician or practitioner reviewers when cases do not meet clinical review criteria
  • Refer cases to other clinicians when appropriate
  • Provide clinical and utilization review subject matter expertise and respond to stakeholder questions or concerns
  • Support quality assurance activities, audits, and other program support as assigned
  • Provide guidance or oversight to non-clinical staff performing support activities, as appropriate
  • Perform other duties as assigned
Work Environment
  • Full-Time
  • 100% Remote (Oregon)
  • Travel required
  • Reliable, secure internet connection required
  • Must maintain licensure eligibility for assigned state contract

Equal Opportunity Employer Comagine Health is an equal opportunity employer and is committed to creating a diverse, equitable, and inclusive workplace.

Physical Requirements & Work Environment

This position is primarily remote and performed in a home-based setting, requiring reliable internet access and a workspace free from significant distractions. The role involves frequent use of computers, phones, and virtual communication tools. Employees must be able to sit for extended periods, communicate effectively.

Some positions may require operating a motor vehicle for business purposes; in such cases, employees must maintain a valid driver's license and meet the organization's driving eligibility requirements. Occasional travel may be required for meetings, training, or other work-related events.

Reasonable accommodations will be provided to enable individuals with disabilities to perform essential functions.

Apply