Remote Clinical Review Supervisor, Utilization Management

Comagine Health; Portland (OR); Remote; USD 95,000 - 125,000; Full time

Benefits offered by this job

Medical coverage

PTO

Retirement match

Adoption assistance

Parental leave

Remote stipend

Job summary

Comagine Health is seeking a Clinical Review Supervisor to provide operational supervision of clinical staff conducting utilization review and specialty reviews. You will guide, train, and support clinical reviewers to ensure accurate determinations of medical necessity and quality of care, while supporting regulatory compliance and collaboration with stakeholders.

This role is based out of Oregon and supports a remote workforce with flexible work arrangements.

Qualifications

• Current, active, unrestricted Oregon LPC, LCSW, LMFT or RN with Behavioral Health experience.
• 5 years of direct patient care clinical experience.
• 1 year of utilization review or medical management experience.
• Graduate degree in social work, psychology, or other behavioral health science field or; Bachelor’s in nursing with behavioral health training.
• Ability to lead teams in a remote work environment.

Responsibilities

• Conduct prospective, concurrent, retrospective, and pre-authorization utilization reviews using InterQual and policies.
• Supervise utilization management, care coordination, and/or case management activities to ensure quality and timeliness.
• Serve as escalation point for complex clinical or operational concerns and communicate to leadership.
• Support quality management initiatives, audits, training, and continuous improvement.
• Conduct onboarding, coaching, performance management, and staff development.
• Review and approve timecards and operational documentation as needed.
• Collaborate with leadership and clients regarding contractual requirements and reporting.
• Maintain a strong customer service focus while supporting organizational goals and accreditation standards.

Skills

Strong communication

Problem-solving

Organizational skills

Leadership (remote)

Customer service

Education

Graduate degree in behavioral health

Bachelor’s in nursing (Oregon licensed)

Tools

InterQual

Job description

Comagine Health is seeking a Clinical Review Supervisor to provide operational supervision of clinical staff conducting utilization review and specialty reviews. You will guide, train, and support clinical reviewers to ensure accurate determinations of medical necessity and quality of care, while supporting regulatory compliance and collaboration with stakeholders.

This role is based out of Oregon and supports a remote workforce with flexible work arrangements.