Supervisor, Clinical CM

Who is Comagine Health?
Comagine Health is a national, mission-driven nonprofit healthcare consulting organization dedicated to improving health and healthcare quality across the United States. For more than 50 years, we have partnered with providers, payers, communities, and government organizations to improve patient outcomes and strengthen healthcare systems.
Our talented remote workforce spans the country, and we actively support flexible remote work while fostering collaboration, innovation, and professional growth. We are committed to creating meaningful work that improves lives.
Benefits
We believe in an environment that allows you to thrive personally and professionally. Benefits 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
Annual remote work stipend
And much more!
Position Summary
The Clinical Review Supervisor provides operational supervision of clinical staff conducting utilization review and specialty review activities. This role is responsible for guiding, training, and supporting clinical reviewers to ensure accurate determinations regarding medical necessity, quality, and appropriateness of healthcare services.
The supervisor also supports operational excellence through quality oversight, staff development, regulatory compliance, and collaboration with internal and external stakeholders.
This position is based out of Oregon.
Key Responsibilities
Conduct prospective, concurrent, retrospective, and pre-authorization utilization reviews using InterQual, an evidence-based clinical criterial tool, organizational policies, and regulatory guidelines
Supervise utilization management, care coordination, and/or case management activities to ensure quality, compliance, timeliness, and contractual performance standards are met
Serve as an escalation point for complex clinical or operational concerns and communicate significant issues to leadership appropriately
Support quality management initiatives, audits, training efforts, and continuous improvement activities
Conduct onboarding, coaching, performance management, and ongoing staff development activities
Review and approve timecards and operational documentation as needed
Collaborate with leadership and clients regarding contractual requirements, operational processes, and reporting activities
Maintain a strong customer service focus while supporting organizational goals and accreditation standards
QualificationsRequired
Oregon Behavioral Health Utilization Management Current, active, unrestricted Oregon LPC, LCSW, LMFT or RN (with Behavioral Health experience) licensure
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 other behavioral health science field or;
Bachelor’s degree in nursing and licensed by the State of Oregon
(with Relevant Training In Behavioral Health Service Delivery) Preferred
Prior supervisory or team leadership experience
Masters degree in Behavioral Health
Experience working within managed care, healthcare consulting, or payer environments
InterQual experience
Equal Opportunity Employer
Comagine Health is an equal opportunity employer and is committed to creating a diverse, equitable, and inclusive workplace.

Work arrangement
Yes