Remote Pediatric Medical Reviewer (Part-Time)

Comagine Health; Washington (District of Columbia); On-site; USD 96,000 - 165,000; Part time

Benefits offered by this job

Fully remote

Flexible hours

Job summary

Comagine Health is seeking a Pediatrician to serve as a Medical Consultant Reviewer on a part-time or per-diem basis. The role involves clinical reviews across Medicaid, Workers' Compensation, and private products, applying evidence-based medicine.

The position is fully remote in the District of Columbia and requires board certification and DC licensure. Flexible, non-clinical work is a strong fit for physicians maintaining clinical practice.

Qualifications

• MD or DO required.
• Pediatrician with Developmental and Behavioral Pediatrics preferred.
• Active DC license or willingness to obtain one.

Responsibilities

• Perform clinical reviews and appeals utilizing pediatric expertise.
• Apply clinical judgment and evidence-based guidelines to render medical necessity determinations.
• Participate in physician-to-physician discussions related to denials.
• Provide clinical subject matter expertise to utilization management staff and case managers.
• Participate in fair hearings and IRR audits to ensure quality and compliance.

Skills

Pediatrician

Clinical review

Evidence-based medicine

Remote work

Board Certification

Education

MD or DO

Job description

Comagine Health is seeking a Pediatrician to serve as a Medical Consultant Reviewer on a part-time or per-diem basis. The role involves clinical reviews across Medicaid, Workers' Compensation, and private products, applying evidence-based medicine.

The position is fully remote in the District of Columbia and requires board certification and DC licensure. Flexible, non-clinical work is a strong fit for physicians maintaining clinical practice.