Remote Behavioral Health Case Reviewer

Comagine Health; Las Vegas (NV); Remote; USD 70,000 - 95,000; Full time

Benefits offered by this job

Medical, dental and vision insurance

Paid time off for vacation, illness, &

Retirement savings plan with employer 

Adoption financial assistance

Paid parental leave.

And much more!

Job summary

Comagine Health is seeking several Behavioral Health / Clinical Reviewer roles across Oregon. The team focuses on evaluating medical necessity and coordinating in-home and community-based care for children, youth, and adults.

Responsibilities include reviews, documentation, and collaboration with stakeholders. Travel to client sites in Oregon is required, with a home-based work setup in a national program.

Qualifications

• QMHP or current, active, unrestricted clinical licensure as required by the Oregon contract
• Master's in physical or occupational therapy or Master’s in psychology, counseling, or social work
• 3 years of clinical (direct patient care) experience; behavioral health preferred

Responsibilities

• Review clinical documentation to determine medical necessity and appropriateness for services
• Perform initial and continued stay reviews using evidence-based criteria
• Document utilization review determinations accurately in designated systems
• Consult with physician or practitioner reviewers when cases do not meet criteria
• Provide clinical and utilization review subject matter expertise to stakeholders
• Support quality assurance activities, audits, and program support

Skills

Clinical experience

Licensure eligibility

Communication skills

MS Office proficiency

Documentation proficiency

Education

Master's in physical or occupational therapy

Master's in psychology, counseling, or social work

Tools

MS Office

Database software

Job description

Comagine Health is seeking several Behavioral Health / Clinical Reviewer roles across Oregon. The team focuses on evaluating medical necessity and coordinating in-home and community-based care for children, youth, and adults.

Responsibilities include reviews, documentation, and collaboration with stakeholders. Travel to client sites in Oregon is required, with a home-based work setup in a national program.