Senior Manager, Clinical Review

Luminare Health

Senior Manager Clinical Review managing department operations in healthcare at Luminare Health. Overseeing staff performance and conducting data analysis to improve efficiency in clinical management.

Posted 5/6/2026full-timeRemote • Alaska, California, Hawaii, New York • 🇺🇸 United StatesSenior💰 $67,600 - $127,000 per yearWebsite

About the role

Key responsibilities & impact

responsible for the daily operations of Clinical Review Department in Healthcare Management
collaborate with the Associate Director
oversight and accountability for the assigned staff performing Utilization Management and Claims Medical Management functions
support work for the Utilization Review Program
conduct analysis of data as it relates to the Healthcare Management processes and outcomes
determine trends, staffing needs and risks to improve the overall effectiveness and efficiency of the department.

Requirements

What you’ll need

Bachelor's Degree
Active state Registered Nurse license in good standing
7 years' experience in direct clinical care or managed care
3 years of management experience
Prior Utilization Management experience
Communicate in a positive and effective manner in both oral and written communication
Read and interpret documents, criteria, instructions, and policy & procedure manuals
Write/create routine correspondence and reports
Speak effectively with co-workers and senior management
Ability to successfully train adult learners and meet the educational needs of those being trained
Critical thinking skills allowing one to apply common sense to carry out instruction furnished in written, oral or diagram form
Must be able to multi-task in an environment that requires organization and prioritization and the ability to address time sensitive assignments
Maintain a high level of confidentiality, flexibility and willingness to learn new tasks and take on new duties as needed
Work in a dynamic team-oriented environment
Work independently with minimal supervision or instruction
Demonstrates knowledge of Microsoft Office Suite products.

Benefits

Comp & perks

health and wellness benefits
401(k) savings plan
pension plan
paid time off
paid parental leave
disability insurance
supplemental life insurance
employee assistance program
paid holidays
tuition reimbursement
other incentives

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Utilization ManagementClaims Medical ManagementClinical ReviewData AnalysisStaffing Needs AssessmentRisk ManagementHealthcare ManagementDirect Clinical CareManaged CareTraining Adult Learners

Soft Skills

Effective CommunicationCritical ThinkingMulti-taskingOrganizationPrioritizationConfidentialityFlexibilityTeam-orientedIndependenceInstructional Skills

Certifications

Bachelor's DegreeRegistered Nurse License