Remote RN: Clinical Review & Healthcare Quality

COMAGINE HEALTH; Albuquerque (NM); Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Remote work WA

Medical insurance

Dental & Vision

401(k) match

Paid time off

Home office stipend

Professional development

Collaborative team environment

Job summary

Comagine Health is seeking an experienced Registered Nurse to join our Washington State remote clinical review team. You will assess medical necessity and care quality, using evidence-based criteria and collaboration with physicians and internal staff to support decision-making.

The role requires an active WA RN license, at least five years of bedside nursing, and strong documentation and communication skills.

Qualifications

• Must hold an active WA RN license.
• Five years of direct clinical nursing experience.
• Ability to interpret clinical guidelines and medical necessity criteria.
• Excellent written and verbal communication and documentation skills.
• Proficiency with electronic medical records and clinical review applications.
• Strong attention to detail, organization, and ability to work independently.

Responsibilities

• Perform prospective, concurrent, and retrospective reviews for inpatient and outpatient services.
• Assess requests against clinical criteria and determine medical necessity.
• Collaborate with physicians and internal teams to ensure accurate determinations.
• Document reviews thoroughly and adhere to contractual standards.

Skills

Clinical assessment

Critical thinking

Communication skills

Documentation review

Organizational skills

Independent work

EMR proficiency

Professionalism

Confidentiality

Education

Bachelor's degree

Tools

EMR systems

Job description

Comagine Health is seeking an experienced Registered Nurse to join our Washington State remote clinical review team. You will assess medical necessity and care quality, using evidence-based criteria and collaboration with physicians and internal staff to support decision-making.

The role requires an active WA RN license, at least five years of bedside nursing, and strong documentation and communication skills.