RN Clinical Review Supervisor (Alabama)
Comagine
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Benefits offered by this job
Job summary
Comagine Health in Alabama is seeking an active RN to supervise the clinical review team. The Supervisor will oversee utilization and specialty reviews, guiding clinical reviewers to assess medical necessity and compliance with criteria and contracts.
The role emphasizes leadership, regulatory knowledge, EMR proficiency, and collaboration with multidisciplinary teams to improve patient outcomes and efficiency.
Qualifications
- Active RN licensed in Alabama in good standing.
- At least 3 years of clinical experience in healthcare.
- At least 1 year of supervisory or team leadership experience in a clinical setting.
- 1 year of medical management/utilization review experience.
- Strong knowledge of clinical review processes and healthcare regulations.
- Proficiency with electronic medical records (EMR).
Responsibilities
- Supervise and train clinical reviewers conducting utilization/specialty reviews.
- Guide staff to identify medical necessity and adherence to criteria and contract guidelines.
- Monitor performance, targets and drive process improvements.
- Communicate effectively with multidisciplinary teams and ensure compliance with standards.
Skills
Education
Tools
Job description
Comagine Health in Alabama is seeking an active RN to supervise the clinical review team. The Supervisor will oversee utilization and specialty reviews, guiding clinical reviewers to assess medical necessity and compliance with criteria and contracts.
The role emphasizes leadership, regulatory knowledge, EMR proficiency, and collaboration with multidisciplinary teams to improve patient outcomes and efficiency.
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