JOB DESCRIPTION Job Summary Provides support for implementation of health plan provider engagement strategies and activities to drive necessary quality and risk adjustment outcomes. Uses a consultative approach, emphasizing physician engagement and behavior change through actionable data and analytics. Drives value-based care strategies through risk adjustment and quality improvement activities. Focuses on smaller, less advanced Tier 2 and Tier 3 providers, ensuring they have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to improve performance through regular meetings and action plans. Addresses practice environment challenges to achieve program goals and improve health outcomes. Tracks engagement activities using standard tools, facilitate data exchanges, and supports training and problem resolution for assigned providers - driving provider participation in Molina's risk adjustment and quality initiatives. Essential Job Duties Provides support for provider engagement activities including enhancing value-based strategies, and risk adjustment/quality improvement initiatives. Ensures assigned Tier 2 and Tier 3 providers have a provider engagement plan to meet annual quality and risk adjustment performance goals. Drives provider partner coaching and collaboration to improve Medicaid, Medicare and Marketplace quality performance and risk adjustment accuracy through consistent provider meetings, action item development, and execution. Works with provider front-office staff to get the Molina members with the most open gaps on the schedule seen by their assigned provider. Coordinates with Health Plan Community and Member Engagement resources to drive supporting effort on the member side. Addresses challenges/barriers in the practice environment impeding successful attainment of program goals and understands solutions required to improve health outcomes. Drives provider participation in Molina risk adjustment and quality efforts (e.g., supplemental data, electronic medical record (EMR) connection, clinical profiles programs) and use of the Molina provider collaboration portal. Tracks all engagement and training activities using standard Molina provider engagement tools to measure effectiveness both within and across Molina health plans. Serves as provider engagement subject matter expert; works collaboratively with health plan and shared service partners to ensure alignment to business goals. Collaborates with assigned health plan Provider Relations Network team member on operational, provider and member issues. Accountable for use of standard Molina Provider Engagement reports and training materials. Develops, organizes, analyzes, documents, and implements processes and procedures as prescribed by health plan and corporate policies. Communicates comfortably and effectively with internal and external stakeholders, including physician leaders, providers, practice managers, and medical assistants within assigned provider practices. Maintains the highest level of compliance. May require same day out-of-office travel up to 80% of the time, depending upon state/health plan requirements. Required Qualifications At least 2 years of experience improving population-level HEDIS quality scores and burden of illness documentation accuracy through provider engagement, or equivalent combination of relevant education and experience. Experience with various managed health care provider compensation methodologies including but not limited to fee-for service (FFS), value-based care (VBC), and capitation. Working knowledge of quality metrics and risk adjustment practices across all business lines. Knowledge and understanding of HEDIS/NCQA and/or CMS STARs quality measures and risk adjustment practices across Medicaid, Medicare, and Marketplace Proficiency with data analysis, manipulation, interpretation, and reporting. Critical-thinking, problem-solving, and analytical skills. Relationship building skills. Attention to detail and organizational skills. Ability to implement process improvement initiatives and drive change. Ability to work independently in a fast-paced, deadline-driven environment. Ability to foster and build relationships in a cross-functional highly matrixed organization to obtain buy-in and drive results. Effective verbal and written communication skills. Microsoft Office suite (including Excel), Power BI, and other applicable software programs proficiency, and ability to learn new information systems and software programs. Preferred Qualifications Bachelor’s degree in Nursing, Health Administration or relevant discipline. Solid understanding of health insurance, provider messaging/design, and project management Strong experience using Microsoft products, including Excel (knowledge of pivot tables, VLOOKUP, etc.) and PowerPoint #PJHPO #LI-AC1 To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $40,851.44 - $70,000 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Advanced Drainage Systems EEO Statement: Advanced Drainage Systems is proud to be an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status, or any other characteristic protected by law. Yard Loader US-MS-Jackson Job ID: 2026-21307 Type: Regular Full-Time # of Openings: 1 Category: Pipe Manufacturing Advanced Drainage Systems Overview Advanced Drainage Systems is a leading manufacturer of stormwater and onsite septic wastewater solutions, committed to sustainability and innovation. With a vast manufacturing and distribution network, we deliver high-quality products across multiple industries while recycling over half a billion pounds of plastic annually. At ADS, we foster a culture where diverse perspectives drive better ideas, ensuring every employee feels valued, heard, and empowered to make an impact. Responsibilities A Yard Loader is responsible for safely and accurately loading and unloading all deliveries made and received by ADS. A Yard Loader must demonstrate safe and proper vehicle operation at all times. This position also interacts with company and non-company drivers as well as will-call customers and should display excellent customer service skills. This position requires the flexibility to work 40+ hours per week and weekends as required. Loaders report directly to the Yard Supervisor and/or Yard Manager. Responsibilities: The responsibilities of this position include, but are not limited to: Embrace a culture of safety. We expect our people to communicate unsafe conditions, acts or injuries immediately Maintain a safe working environment that includes the consistent use of Personal Protection Equipment to ensure your safety Safely operate a forklift and conduct preventative maintenance on forklifts and other machines in the plant Ensure quality by conducting final visual inspections and labeling all finished goods Promote good customer service skills when loading and unloading deliveries while minimizing errors Ensure proper product rotation and tracking of inventory levels Ability to learn and stay current on pipe specifications and packaging requirements Practice continuous improvement with regard to process and facility housekeeping Invest in your career with ADS. Build and maintain job skills and additional earning potential through company training programs Other duties as assigned Job Skills: This position should possess the following skills/knowledge: Self-motivated and the ability to work independently Energetic and thrive in a fast paced environment Basic inventory management skills Forklift operation Dependability Ability to learn new skills Team-oriented Basic mathematical skills Educational Requirements: High School Diploma or equivalent Preferred Experience: Previous warehouse, industrial or manufacturing experience Benefits We offer a competitive salary and an excellent benefits program including: Medical Dental Vision Flexible Spending Accounts (Health Care and Dependent Care) Company-Paid Life and AD&D Insurance Short-Term and Long-Term Disability Programs Profit Sharing Plan (401k) Paid Holidays/ Vacation Days Bereavement Pay Jury Duty Military Leave Leadership Competencies EEO Statement ADS supports an inclusive workplace that values diversity of thought, experience, and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. ADS is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law. EEO Statement ADS supports an inclusive workplace that values diversity of thought, experience, and background. We celebrate the power of our differences to create better solutions for our customers by ensuring employees can be their authentic selves each day. ADS is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, ancestry, age, physical or mental disability, sex, sexual orientation, gender identity/expression, pregnancy, veteran status, marital status, creed, status with regard to public assistance, genetic status or any other status protected by federal, state or local law. Equal employment opportunity, including veterans and individuals with disabilities. PI286258787

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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! Senior Healthcare Data Analyst Location: Remote Employment Type: Full-Time Overview We are seeking a Senior Healthcare Data Analyst to lead advanced analytics in a multidisciplinary environment. This role designs and executes analytic strategies that support quality improvement, research, care management, and analytic services—helping stakeholders use data effectively to improve health care outcomes and measure success. The ideal candidate brings deep technical expertise, strong communication skills, and the ability to deliver clinically, scientifically, and statistically sound analyses on time. Advanced coding proficiency in SAS, SQL, R, Python, or similar languages is a must. Key Responsibilities Design and lead analytics for quality improvement, research, and care management projects Develop and maintain dashboards, reports, and ad hoc analyses Serve as a subject matter expert on healthcare data interpretation and use Apply advanced statistical methods and programming solutions Standardize analytic and reporting processes and documentation Translate complex data into clear insights for leadership and stakeholders Mentor and provide guidance to less-experienced analysts Partner with IT and data governance teams to ensure data integrity and compliance Qualifications BA/BS in epidemiology, statistics, mathematics, computer science, social sciences, or related field (or equivalent experience) Master’s degree preferred 8+ years of healthcare-related data analysis or research experience Advanced coding proficiency in SAS, SQL, R, Python, or similar languages Experience with large datasets, relational databases, and data visualization tools (Tableau, Power BI, or similar) Strong knowledge of statistics/biostatistics and analytic methodologies Excellent communication, problem-solving, and attention to detail Preferred Project management or supervisory experience Study design experience Additional Information Minimal travel required Competitive compensation and comprehensive benefits package Equal Opportunity Employer We are committed to building a diverse and inclusive workplace and encourage candidates from all backgrounds to apply. 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. Equal employment opportunity, including veterans and individuals with disabilities. PI286013786

Why Comagine Health? Comagine Health is a national, mission-driven nonprofit organization dedicated to improving health care quality and advancing better outcomes for communities across the United States. For more than 50 years, we have partnered with providers, health systems, and government agencies to support evidence-based care, quality improvement, and better health outcomes. Our remote workforce collaborates across the country to deliver meaningful work that improves lives and strengthens health care systems. Applied Behavior Analysis (ABA) Consultant – Alabama | PRN / On-Call We are seeking an experienced Applied Behavior Analysis (ABA) Consultant to support a Medicaid Prior Authorization (PA) program reviewing ABA therapy services. In this role, the consultant will apply expertise in ABA treatment models, Medicaid ABA policy, medical necessity criteria, and nationally recognized ABA practice standards when evaluating authorization requests. The consultant will review PA requests, ensure consistent application of Medicaid policy, and support appropriate service delivery. Requirements • Must reside in Alabama • BCBA certification in good standing with the Behavior Analyst Certification Board (BACB) • Master’s degree in Applied Behavior Analysis, Psychology, Psychiatry, or related field • Active Alabama license as a Licensed Psychologist or Licensed Psychiatrist • Experience with ABA treatment review, Medicaid policy, or utilization management preferred Equal Opportunity Employer. Equal employment opportunity, including veterans and individuals with disabilities. PI286015067

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. You’ll have the opportunity to make an impact from anywhere in the U.S. while contributing to meaningful improvements in health care delivery. Position Overview Comagine Health is seeking a Consultant to support our Health System Improvement team , with a focus on Long Term Care Facilities. In this role, you will provide consulting services across clinical, operational, public health, and quality improvement domains to help clients navigate the evolving health care landscape and improve outcomes. Minimum hours 15 per week; potential to flex to 40 based on project needs. This position serves as a subject matter expert, leading projects, engaging stakeholders, and delivering impactful solutions that strengthen health systems, particularly within long-term care and skilled nursing environments. Services will be provided through a combination of on-site and virtual support. Key Responsibilities Consulting & Program Delivery (60%) Lead and deliver consulting services across long-term care facilities Facilitate meetings, strategy sessions, and learning collaboratives Design and implement health system improvement initiatives, with emphasis on quality and regulatory performance in long term care facilities Develop and deliver training curricula, educational programs, and large-scale improvement efforts Project Leadership & Management (30%) Lead project planning, execution, and delivery with strong client focus Define project scope, goals, and deliverables in collaboration with internal teams and clients Develop and manage project plans, timelines, and milestones Monitor progress, track deliverables, and provide status reporting Maintain project documentation including meeting notes, schedules, and reports Business Development & Thought Leadership (10%) Represent Comagine Health at meetings, conferences, and industry events Present as a subject matter expert at local, state, and national forums Contribute to proposal development and new business opportunities Qualifications Required: Experience in health care consulting, quality improvement, public health, or health system transformation Strong familiarity with Long-term care facility regulatory requirements Experience working with or supporting long-term care facilities in quality improvement Demonstrated ability to lead projects and manage multiple priorities simultaneously Strong facilitation, communication, and stakeholder engagement skills Experience developing and delivering training or educational content Ability to work independently in a remote environment BSN Preferred: Advanced degree (e.g., MPH, MHA, MSN, or related field) Experience with health system improvement initiatives, population health, or care delivery transformation Familiarity with long-term care regulations, quality measures, and survey readiness Prior experience with learning collaboratives or large-scale improvement programs Work Environment Travel 25-50% of work Remote when not traveling, U.S.-based Minimum hours 15 per week; potential to flex to 40 based on project needs Equal Opportunity Employer Comagine Health is an equal opportunity employer and is committed to creating a diverse, equitable, and inclusive workplace. Equal employment opportunity, including veterans and individuals with disabilities. PI286014834

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. Position Overview We are seeking an RN to perform Clinical Review work and QIDP reviews work. Team member will serve as the QIDP (.5 FTE) and as a nurse clinical reviewer (.5 FTE). Key Responsibilities Apply Alabama Medicaid program criteria and guidelines to determine the medical necessity of health care services. Intermediate Care Facilities for Individuals with Intellectual Disabilities experience. Complete reviews within timelines established by all applicable state and federal requirements. Consult and forward to a Physician Advisor/ Consulting Physician all cases for which a medical necessity determination cannot be rendered. Work with administrative support, as appropriate. Identify customer needs and expectations and responds to them in a timely and effective manner. Anticipate and prevent delays or other adverse impacts to customers and keep them informed about the status of pending actions and inquiries. Attend, upon request, Medicaid meetings, fair hearings, meetings, and hearings of legislative committees and interested governmental bodies, agencies, and officers. Education & Experience BA/BS in Nursing Active RN in the Alabama. Minimum of 3 years of direct patient care (clinical) experience Licensure Current, active, unrestricted RN license Alabama Required Skills & Competencies All nurse reviewers will be located and licensed within Alabama and in good standing with the Alabama Board of Nursing and Board of Medical Examiners. Experience with: Performing PA reviews Long-term care including nursing home, ICF/IID, swing bed, PEC, and inpatient psychiatric facilities Provider relations Reporting Work Environment 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. Equal employment opportunity, including veterans and individuals with disabilities. PI286014122

Clinical Manager, Care Management Exempt | Full-Time | Remote - Alaska, Washington, Oregon. Why Comagine Health? At Comagine Health, our work improves the quality, safety, and value of healthcare across the country. We're looking for an experienced clinical leader who is passionate about developing high-performing teams, improving healthcare outcomes, and ensuring quality, compliance, and exceptional service. If you're a collaborative RN leader with utilization management experience, you'll have the opportunity to shape clinical operations while supporting a mission that positively impacts patients, providers, and communities. What We Offer Fully remote work environment (U.S.) Comprehensive medical, dental, and vision coverage 401(k) with company match Generous paid time off and holidays Professional development opportunities A collaborative, mission-driven culture Core Description / Role Purpose The Manager, Clinical Care Management oversees the delivery of clinical services, ensuring the integrity, consistency, and high quality of care management programs. This role provides leadership for clinical teams, promotes operational excellence, fosters strong customer relationships, and contributes to organizational growth through business and product development initiatives. Primary Job Duties Oversee Clinical Service Delivery (40%) Lead the delivery of high-quality utilization management, case management, and care coordination services. Ensure services are delivered in accordance with operational policies, clinical guidelines, quality management practices, contractual obligations, accreditation standards, regulatory requirements, and organizational objectives. Promote continuous quality improvement while maintaining exceptional clinical outcomes and customer satisfaction. Monitor Financial and Operational Performance (10%) Monitor productivity, staffing, and financial performance to ensure efficient and effective service delivery. Assist with annual budgeting and workforce planning. Review key operational and financial metrics and implement corrective actions when needed to improve performance. Lead and Develop Clinical Staff (20%) Supervise and develop clinical team members through coaching, training, regular check-ins, and performance management. Approve and manage staff timesheets. Foster employee engagement, accountability, and professional growth. Collaborate Across the Organization (10%) Partner with Care Management, Medical Affairs, and cross-functional teams to develop and implement clinical policies, procedures, workflows, guidelines, and quality improvement initiatives. Encourage collaboration that supports consistent, high-quality clinical services. Build Strong Customer Relationships (10%) Maintain high levels of customer satisfaction by working collaboratively with clients, providers, patients, and other stakeholders. Resolve concerns through prompt, effective communication and proactive problem solving. Support Business Growth (5%) Participate in new business proposal development and product development initiatives. Represent Comagine Health during customer meetings, conference calls, educational seminars, and other business development activities. Provide Clinical Leadership Support (5%) Provide direct utilization management or case management support when increased workloads or complex cases require leadership involvement. Serve as a clinical resource and mentor to staff while ensuring continuity of service delivery. What You'll Bring Required Qualifications Active, unrestricted Registered Nurse (RN) license or LMHC. Bachelor's degree in Nursing, Healthcare Administration, or a related field, or an equivalent combination of education and experience. Five (5) or more years of experience in Case Management, Care Management, Care Coordination, and/or Utilization Management . Two (2) or more years of leadership or management experience with responsibility for supervising clinical staff, managing operations, and overseeing financial performance. Demonstrated success leading clinical teams while driving operational excellence, quality outcomes, and continuous process improvement. Strong communication, interpersonal, and relationship-building skills with the ability to collaborate effectively across multidisciplinary teams. Ability to analyze operational, financial, and productivity metrics and implement strategies to improve performance. Preferred Qualifications Certification in Case Management, Utilization Management, or a related healthcare management discipline (CCM, IQCI, or equivalent). Experience working with Medicaid, Medicare, and/or commercial health insurance programs. Strong knowledge of healthcare quality improvement methodologies, utilization management practices, accreditation standards, regulatory compliance, and clinical operations. Experience leading remote or geographically dispersed clinical teams. Why You'll Succeed We're looking for a leader who thrives in a collaborative environment, communicates effectively, develops people, and uses data to improve performance. You'll be empowered to build strong teams, solve complex operational challenges, and make a meaningful impact on healthcare quality nationwide. Join Comagine Health and help lead the future of high-quality, patient-centered care. Comagine Health is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive workplace for all employees and applicants Equal employment opportunity, including veterans and individuals with disabilities. PI286012706

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. Position Overview We are seeking Clinical Utilization Review Nurses (RN) based in Alabama to assess the medical necessity and quality of healthcare services through prospective, concurrent, and retrospective utilization management reviews. This full-time, remote position supports high-quality, appropriate, and cost-effective care while ensuring compliance with clinical criteria, organizational policies, and contract requirements specific to Alabama. Key Responsibilities Apply Alabama Medicaid program criteria and guidelines to determine the medical necessity of health care services. Complete reviews within timelines established by all applicable state and federal requirements. Consult and forward to a Physician Advisor/ Consulting Physician all cases for which a medical necessity determination cannot be rendered. Work with administrative support, as appropriate. Identify customer needs and expectations and responds to them in a timely and effective manner. Anticipate and prevent delays or other adverse impacts to customers and keep them informed about the status of pending actions and inquiries. Attend, upon request, Medicaid meetings, fair hearings, meetings, and hearings of legislative committees and interested governmental bodies, agencies, and officers. Education & Experience BA/BS in Nursing Active RN in the Alabama. Minimum of 3 years of direct patient care (clinical) experience Licensure Current, active, unrestricted RN license Alabama Required Skills & Competencies All nurse reviewers will be located and licensed within Alabama and in good standing with the Alabama Board of Nursing and Board of Medical Examiners. Experience with: Performing PA reviews Long-term care including nursing home, ICF/IID, swing bed, PEC, and inpatient psychiatric facilities Provider relations Reporting Work Environment 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. Equal employment opportunity, including veterans and individuals with disabilities. PI286014358

About Company: 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! Comagine Health actively cultivates an organizational culture that fosters well-being and prioritizes engagement, connectedness and collaboration among team members. Each employee’s unique background, perspective and abilities are fundamental to the success of our mission and organization. Comagine Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. We are proud to be a Recovery Friendly Workplace, supporting the health and well-being of all employees. About the Role: This role requires that the employee is an active RN and based in Alabama. The Supervisor, Clinical Review plays a critical role in providing operational supervision of clinical staff who conduct utilization review and/or specialty reviews. The Clinical Review supervisor will guide and monitor, and train clinical reviewers to identify medical necessity/medical appropriateness as identified by identified criteria, specific contract guidelines, and/or organizational clinical criteria. Minimum Qualifications All nurse reviewers will be located and licensed within Alabama and in good standing with the Alabama Board of Nursing and Board of Medical Examiners. Experience with: Performing PA reviews Long-term care including nursing home, ICF/IID, swing bed, PEC, and inpatient psychiatric facilities Minimum of 3 years of clinical experience in a healthcare setting. At least 1 year of supervisory or team leadership experience in a clinical environment. 1 year of medical management / utilization review experience Strong knowledge of clinical review processes, healthcare regulations, and medical terminology. Proficiency with electronic medical records (EMR) systems and clinical documentation standards. Preferred Qualifications: LCSW, LPC licensure or equivalent clinical certification. 3 years of medical management / utilization review experience Experience with health plan operations or managed care organizations. Familiarity with state and federal healthcare regulations, including HIPAA and CMS guidelines. 5 years of clinical (direct patient care) experience Responsibilities: The supervisor, will display, critical thinking abilities, strong leadership skills, wise decision-making abilities, organized, knowledgeable and excellent communicator. Demonstrated leadership ability within a team, including management of personnel, meeting targets, and facilitating process improvement efforts. Competent in understanding medical/clinical terminology, diagnoses, and documentation Skills: The required skills enable the supervisor to effectively lead clinical review teams by applying clinical knowledge to evaluate patient care documentation and ensure compliance with healthcare standards. Strong communication and interpersonal skills are essential for collaborating with multidisciplinary teams and resolving clinical issues efficiently. Analytical skills are used daily to interpret clinical data, identify trends, and implement quality improvement initiatives. Proficiency with EMR systems and clinical software supports accurate documentation review and reporting. Preferred skills such as advanced certifications and familiarity with regulatory frameworks enhance the supervisor’s ability to navigate complex healthcare environments and drive continuous improvement in clinical review processes. Equal employment opportunity, including veterans and individuals with disabilities. PI286014591