Remote Clinical Utilization Review Supervisor

Comagine.org; Oregon; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Paid time off for vacation, illness, &

Retirement savings plan with employer

Adoption financial assistance

Paid parental leave

Annual remote work stipend

Job summary

Comagine Health in Oregon is seeking a Clinical Review Supervisor to lead clinical reviewers and oversee utilization review activities, ensuring medical necessity and compliance. You will coach staff, monitor quality, and collaborate with stakeholders to support accurate determinations.

The role emphasizes remote management, staff development, adherence to InterQual criteria, and strong customer service as part of a mission-driven nonprofit health care consultancy.

Qualifications

• Active Oregon behavioral health license (LPC/LCSW/LMFT or RN)
• 5 years of direct patient care clinical experience
• 1 year of utilization review or medical management experience
• Strong communication, problem-solving, organizational, and customer service skills
• Ability to lead teams in a remote work environment
• Graduate degree in social work, psychology, or behavioral health science
• Bachelor’s degree in nursing and Oregon licensure (with behavioral health training)

Responsibilities

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

Skills

Communication

Leadership

Remote work

Problem solving

Customer service

Time management

Education

Graduate degree in behavioral health

Bachelor's degree in nursing

Job description

Comagine Health in Oregon is seeking a Clinical Review Supervisor to lead clinical reviewers and oversee utilization review activities, ensuring medical necessity and compliance. You will coach staff, monitor quality, and collaborate with stakeholders to support accurate determinations.

The role emphasizes remote management, staff development, adherence to InterQual criteria, and strong customer service as part of a mission-driven nonprofit health care consultancy.