Remote Behavioral Health Case Manager & Clinical Reviewer

Preferra Insurance; Jackson (MS); Hybrid; USD 65,000 - 95,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

PTO

Retirement plan

Adoption assistance

Parental leave

Job summary

Comagine Health is seeking Behavioral Health / Clinical Reviewer roles across Oregon, with travel to client sites and home-based work. Review clinical documentation for medical necessity, perform utilization reviews, and coordinate care for children, youth, and adults in home and community settings.

The positions require licensure and appropriate clinical credentials, with statewide travel across Oregon. The team emphasizes collaboration, accountability, and effective use of technology to

Qualifications

• QMHP or active, unrestricted licensure as required by Oregon contract
• Master's degrees in psychology/counseling/social work or in physical/occupational therapy
• Minimum 3 years of direct clinical experience in behavioral health

Responsibilities

• Review clinical documentation to determine medical necessity and appropriateness of services
• Perform initial and continued stay reviews using evidence-based criteria
• Document utilization review determinations accurately in designated systems
• Travel for in-person assessments as needed within assigned region
• Support quality assurance activities and audits

Skills

Clinical documentation review

Utilization review

Communication skills

Organizational skills

MS Office

Interpersonal skills

Problem solving

Education

QMHP licensure OR clinical licensure

Master's in psychology, counseling, or social work

Master's in physical or occupational therapy

Tools

MS Office

Database software

EMR systems

Job description

Comagine Health is seeking Behavioral Health / Clinical Reviewer roles across Oregon, with travel to client sites and home-based work. Review clinical documentation for medical necessity, perform utilization reviews, and coordinate care for children, youth, and adults in home and community settings.

The positions require licensure and appropriate clinical credentials, with statewide travel across Oregon. The team emphasizes collaboration, accountability, and effective use of technology to