[Hiring] Medical Consultant Reviewer @Comagine Health

Role Description

Comagine Health is seeking a Board-Certified Internal Medicine, Emergency Medicine, or Family Practice physician to serve as a Medical Consultant Reviewer on a part-time or per-diem basis. This role performs clinical reviews and appeals across multiple lines of business, including Medicaid, Workers’ Compensation, and private healthcare products, applying evidence-based medicine and sound clinical judgment. This position is fully remote within Washington. Other areas can be considered (Oregon). This position is well suited for physicians looking for flexible, non-clinical work while maintaining an active or reduced clinical practice.

Key Responsibilities

• Perform clinical reviews and appeals utilizing Internal Medicine, Emergency Medicine or Family Practice expertise.
• Apply clinical judgment and evidence-based guidelines to render timely, defensible medical necessity determinations.
• Participate in physician-to-physician discussions, including those related to potential denials.
• Provide clinical subject matter expertise to utilization management staff, case managers, and consultants.
• Participate in fair hearings, representing clinical determinations when required.
• Take part in Inter-Rater Reliability (IRR) audits to ensure consistency and quality.
• Ensure reviews meet standards for clear documentation, regulatory compliance, and sound decision-making.

Qualifications

• MD or DO required.
• Active, current, unrestricted MD or DO license in the state of Washington or willing to obtain this.
• Board Certification in Internal Medicine, Emergency Medicine or Family Practice (ABMS or ABOS).
• Minimum of 7 years of clinical practice experience preferred.
• Preferred current or recent clinical practice in Internal, Emergency Medicine or Family Practice.
• Prior utilization management, peer review, or appeals experience (helpful but not required).

Benefits

• Medical, dental and vision insurance.
• Paid time off for vacation, illness and volunteering.
• Retirement savings plan with employer contribution.
• Adoption financial assistance.
• Paid parental leave.
• And much more!

Physical Requirements & Work Environment

This position is primarily remote and performed in a home-based setting, requiring reliable internet access and a workspace free from significant distractions. The role involves frequent use of computers, phones, and virtual communication tools. Employees must be able to sit for extended periods and communicate effectively. Some positions may require operating a motor vehicle for business purposes; in such cases, employees must maintain a valid driver’s license and meet the organization’s driving eligibility requirements. Occasional travel may be required for meetings, training, or other work-related events. Reasonable accommodations will be provided to enable individuals with disabilities to perform essential functions.