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Entry level
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Senior
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Eugene, Oregon, United States · On-site
Mid level
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Primary Care Functional Medicine - Nurse Practitioner
Eugene, Oregon, United States · Hybrid
$300k/yr
Mid level
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Pacific Retirement Services
CNA
Eugene, Oregon, United States · On-site
Entry level
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Skills: Patient Care, Communication Skills, Teamwork, Nursing Services, Long-term Care
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$75k–$90k/yr
Full-time
professional certificate
Medical insurance, Dental insurance, Vision insurance, Paid time off, Retirement savings plan, Adoption financial assistance
Posted 12d ago
~40 hrs/week
Remote in Eugene, Oregon, United States
Responsibilities
The Clinical Reviewer evaluates clinical documentation to determine the medical necessity and appropriateness of behavioral health services. They also conduct functional needs assessments and coordinate care for individuals across community-based settings.
Requirements
Candidates must hold an active, unrestricted clinical licensure in Oregon, such as LCSW or LPC, and possess at least 3 years of direct patient care experience. The role requires residency in Oregon, a valid driver's license, and the ability to travel for in-person assessments.
Full job description
Are you passionate about improving access to behavioral health services in the community? Do you enjoy using your clinical expertise to evaluate needs, support care decisions, and help individuals receive the right services at the right time?
In this role, you will review clinical documentation to determine medical necessity and appropriateness of services, complete functional needs assessments that evaluate how mental health symptoms impact daily living, and support service coordination that connects children, youth, and adults to in-home and community-based care. You will manage referrals, follow-ups, reviews, and assessments within an electronic medical record system; apply evidence-based criteria to utilization management reviews; document clinical determinations; provide subject matter expertise to stakeholders; support quality activities and audits; and travel for in-person assessments as needed across your assigned region.
If you are someone who demonstrates strong clinical judgment, builds trusting relationships with members and partners, and effectively manages a high-volume workload while meeting timelines, we encourage you to apply. If you bring a collaborative mindset, accountability in your work, curiosity to ask questions and learn, and comfort using technology to navigate systems and documentation, you will be well-positioned for success on this team. This is a remote position based in Eugene, Oregon and travel is required in the Eugene, Oregon and surrounding areas.
Why Comagine Health?
Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years.
We are leaders in assisting front-line providers and engaging health care partners to improve care delivery and patient outcomes.
Our talented remote workforce spans the country and plays a vital role in our success. We go beyond merely providing a remote work option; we support and embrace it. We offer opportunities to make a difference from anywhere in the U.S. and enjoy better work-life balance. An annual stipend gives you the freedom to enhance your workspace with options that suit your needs.
We believe in an environment that allows you to thrive both personally and professionally. That’s why we offer benefits that 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.
And much more!
You Have (Required Qualifications)
Current, active, unrestricted clinical licensure as required by the Oregon contract (e.g., behavioral health licensure such as LCSW, LPC, LCPC)
3 years of clinical (direct patient care) experience; behavioral health preferred
Candidates must reside in Oregon, have personal transportation, and ability to travel. Valid Driver License and Proof of Auto Insurance are required.
You May Have (Desired Qualifications)
Experience with Medicaid
Knowledge of the Oregon behavioral health system of care
2 years of utilization review or other medical management experience
2 years of full-time substance use disorder and/or behavioral health disorder experience
You Bring (Competencies)
Clinical documentation review expertise, including use of the Oregon Health Plan Prioritized List of Health Services and InterQual
Strong organizational skills and ability to manage multiple tasks in a team environment
Excellent oral and written communication skills
Strong interpersonal and problem-solving skills
Proficiency with MS Office Suite and familiarity with database software
Ability to apply clinical review criteria, policies, and guidelines to determine medical necessity
Ability to document utilization review determinations accurately and timely in designated systems
Capability to provide clinical and utilization review subject matter expertise and respond to stakeholder questions or concerns
In this Role, You Will
Review clinical documentation to substantiate medical necessity and appropriateness for requested services
Perform initial and continued stay reviews using standardized, evidence-based criteria to ensure services align with individualized behavioral health needs
Apply clinical review criteria, organizational policies, guidelines, and screening tools to determine medical necessity of healthcare services
Document utilization review determinations accurately and timely in designated systems
Consult with physician or practitioner reviewers when cases do not meet clinical review criteria
Refer cases to other clinicians when appropriate
Provide clinical and utilization review subject matter expertise and respond to stakeholder questions or concerns
Support quality assurance activities, audits, and other program support as assigned
Provide guidance or oversight to non-clinical staff performing support activities, as appropriate
Perform other duties as assigned
Work Environment
Full-Time
100% Remote (Oregon)
Travel required
Reliable, secure internet connection required
Must maintain licensure eligibility for assigned state contract
Equal Opportunity Employer Comagine Health is an equal opportunity employer and is committed to creating a diverse, equitable, and inclusive workplace.
Physical Requirements & Work Environment
This position is primarily remote and performed in a home-based setting, requiring reliable internet access and a workspace free from significant distractions. The role involves frequent use of computers, phones, and virtual communication tools. Employees must be able to sit for extended periods, communicate effectively.
Some positions may require operating a motor vehicle for business purposes; in such cases, employees must maintain a valid driver’s license and meet the organization’s driving eligibility requirements. Occasional travel may be required for meetings, training, or other work-related events.
Reasonable accommodations will be provided to enable individuals with disabilities to perform essential functions.
Related keywords
Clinical ReviewerBehavioral HealthUtilization ManagementMedical NecessityLCSWLPCLCPCOregon Health PlanInterQualElectronic Medical RecordCase ManagementQuality AssuranceAuditsPatient OutcomesHealthcare ConsultingRemote Work
Comagine Health is a national, nonprofit, health care consulting firm.
We work collaboratively with patients, providers, payers and other stakeholders to reimagine, redesign and implement sustainable improvements in the health care system. As a trusted, neutral party, we work in our communities to address key, complex health and health care delivery problems. In all our engagements and initiatives, we draw upon our expertise in quality improvement, care management, health information technology, analytics and research.
We invite our partners and communities to work with us to improve health and redesign the health care delivery system.
Mission:
Together with our partners, we work to improve health and create a better health care system so that people and communities will flourish.
Get social with us:
x.com/comaginehealth
facebook.com/comaginehealth
Join our team:
https://comagine.org/careers
Send a message: https://comagine.org/contact
Offices: 10700 Meridian Ave. N., Suite300, Seattle, WA 98133, US · P.O. Box 53078, Birmingham, AL 35253, US · P.O. Box 243609, Anchorage, AK 99524, US · P.O. Box 34800, Washington, DC 20043, US · 6830 W. Oquendo Road, Suite 102, Las Vegas, NV 89118, US
quality improvementcare managementanalyticshealth information technologyresearch and evaluationdata solutionsexternal quality reviewutilization managementand case managementHealth Diagnostics
How many Healthcare jobs are open in Eugene, OR right now?
There are currently 376 open healthcare positions in Eugene, OR listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Healthcare roles in Eugene, OR?
Companies currently hiring include Volare Health, LLC, BenchMark Physical Therapy, The US Oncology Network, UnitedHealth Group, Avamere Skilled Advisors, LLC, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Healthcare jobs in Eugene, OR?
Yes — 32 of the 376 open healthcare positions offer remote or hybrid work (13 remote, 19 hybrid).
How do I apply for Healthcare jobs in Eugene, OR?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.