Remote RN Clinical Reviewer — Healthcare Quality

Comagine Health; Murray (UT); À distance; USD 90 000 - 130 000; Plein temps

Avantages offerts par ce poste

Medical, dental, vision insurance

401(k) with company match

Generous PTO and holidays

Home office stipend

Résumé du poste

Comagine Health is seeking an experienced Registered Nurse (RN) to join our Washington Labor & Industries contract as a Clinical Reviewer. This remote role focuses on evaluating medical necessity, quality, and appropriateness of services, with opportunities to collaborate with physicians and internal teams.

The ideal candidate holds an active WA RN license, has 5+ years of direct patient care, and is proficient with EMR systems.

Qualifications

• RN license in WA (active, unrestricted)
• Minimum 5 years of clinical nursing experience
• Ability to interpret clinical guidelines and criteria
• Strong written and verbal communication skills
• Proficiency with EMR and clinical review tools

Responsabilités

• Conduct prospective, concurrent, and retrospective clinical reviews
• Evaluate requests against clinical criteria and guidelines
• Collaborate with physicians and internal teams to ensure quality reviews
• Document reviews accurately and in accordance with procedures and contracts
• Maintain confidentiality and comply with regulatory requirements

Connaissances

Clinical assessment

Critical thinking

Communication

Documentation & confidentiality

EMR proficiency

Formation

Bachelor’s degree

Outils

EMR software

Description du poste

Comagine Health is seeking an experienced Registered Nurse (RN) to join our Washington Labor & Industries contract as a Clinical Reviewer. This remote role focuses on evaluating medical necessity, quality, and appropriateness of services, with opportunities to collaborate with physicians and internal teams.

The ideal candidate holds an active WA RN license, has 5+ years of direct patient care, and is proficient with EMR systems.