$93,000 - $104,000 yearly
Comagine Health
Las Vegas, NV
Are you passionate about using your clinical expertise to support quality healthcare outcomes and ensure members receive medically appropriate services? Do you enjoy critically reviewing clinical documentation, applying evidence-based criteria, and collaborating with interdisciplinary teams to make informed medical necessity determinations? We're are recruiting for 2 full-time remote/hybrid Clinical Reviewer positions. This position is currently remote but may have minimal travel requirements to the DC office in the future. Candidates must reside in DC, Maryland or Virginia and a commutable distance to DC. The Clinical Reviewer position supports utilization management activities by assessing the medical necessity and quality of healthcare services through prospective, concurrent, and retrospective reviews. This role reviews clinical documentation, applies clinical review criteria and organizational policies, documents review findings, communicates determinations,...