Oregon Licensed Utilization Review Supervisor

Job Summary

A company is looking for a Supervisor of Utilization Review.

Key Responsibilities

• Oversee daily operations of the utilization review team and ensure compliance with payer guidelines
• Provide leadership, training, and guidance to utilization review staff
• Collaborate with clinical teams and payer representatives to minimize denials and improve reimbursement outcomes

Required Qualifications, Training, and Education

• Minimum of 2 years of leadership experience in utilization review or clinical documentation integrity
• Additional 2 years of nursing experience in clinical practice areas
• Bachelor's degree in nursing or equivalent education and experience preferred
• Registered Nurse licensed by the Oregon State Board of Nursing
• Preferred certifications include CCM, ACM, CCS, CPC, CCS-P, or CRC