Clinical Reviewer

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.

Comagine Health is looking for a remote RN Clinical Reviewer to support our growing team. This role will support a variety of patient populations across the organization, providing utilization management and care planning as needed.

Participate in a multi-disciplinary team to improve the quality of healthcare for individuals and populations. Apply nationally-recognized clinical criteria and guidelines to determine the medical necessity of inpatient admissions, outpatient procedures, and other healthcare services. Consult with physicians or refer cases to others, when indicated.