Remote RN Clinical Reviewer & QIDP for IDD Care

COMAGINE HEALTH; Murray (UT); Remote; USD 64,000 - 82,000; Part time

Benefits offered by this job

Annual workspace stipend

Job summary

Comagine Health is seeking an RN to perform Clinical Review work and QIDP reviews. The team member will serve as the QIDP (.5 FTE) and as a nurse clinical reviewer (.5 FTE). The role requires applying Alabama Medicaid criteria to determine medical necessity and leveraging ICF/IID experience.

The position is primarily remote, with licensing in Alabama and ongoing travel as needed. Minimum of 3 years of direct patient care, a BSN, and an active Alabama RN license are required.

Qualifications

• Active RN license in Alabama is required.
• Minimum of 3 years of direct patient care experience.
• Bachelor of Science in Nursing required.

Responsibilities

• Apply Alabama Medicaid criteria to determine medical necessity.
• Utilize ICF/IID and long-term care expertise in reviews.
• Complete reviews within state/federal timelines.
• Consult physician advisor on complex cases.
• Coordinate with administrative support as needed.
• Identify customer needs and respond promptly.

Skills

Nursing

Clinical review

Provider relations

Reporting

Education

BA/BS in Nursing

Job description

Comagine Health is seeking an RN to perform Clinical Review work and QIDP reviews. The team member will serve as the QIDP (.5 FTE) and as a nurse clinical reviewer (.5 FTE). The role requires applying Alabama Medicaid criteria to determine medical necessity and leveraging ICF/IID experience.

The position is primarily remote, with licensing in Alabama and ongoing travel as needed. Minimum of 3 years of direct patient care, a BSN, and an active Alabama RN license are required.