Supervisor, Clinical Review

🕒 May 29

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Comagine Health

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 1973

🤝 Non-profit

🤝 B2B

🔬 Science

Non-profit • B2B • Science

Comagine Health is a national nonprofit health care consulting organization that partners with providers, payers, public agencies, community organizations and consumers to improve health care quality, equity, and outcomes. It offers systemwide quality improvement, care management, data solutions, research and evaluation, and COVID-19 response services, using health information exchange and health IT to inform public health surveillance and program design. Comagine focuses on supporting community health, behavioral health, and patient-centered initiatives through technical assistance, evaluation, and collaborative systems-level work.

📋 Description

• 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

🎯 Requirements

• Associate degree (AA/AS) • Current, active, unrestricted RN license • 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

🏖️ Benefits

• 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!