[Hiring] Medical Consultant Reviewer - Psychiatrist @Comagine Health

Role Description

Comagine Health is seeking a psychiatrist. Clinical experience or board certification in Adolescent Psychiatry preferred, to serve as an Assistant Medical Director 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. Need to obtain licensure in the State of Washington. 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 pediatrician 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.
• Psychiatrist. Clinical experience or board certification in Adolescent Psychiatry preferred.
• Active, current, unrestricted MD or DO license in the State of Washington or willing to obtain this.
• Minimum of 7 years of clinical practice experience preferred.
• Prior utilization management, peer review, or appeals experience (helpful but not required).

Requirements

• Reliable internet access and a workspace free from significant distractions.
• Ability to sit for extended periods and communicate effectively.
• Some positions may require operating a motor vehicle for business purposes; 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.

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!

Company Description

Comagine Health is a national, mission-driven, nonprofit organization that has engaged in health care quality consulting and quality improvement services for more than 50 years. We are leaders in assisting front-line providers and engaging health care partners to improve care delivery and patient outcomes.

Our talented remote workforce spans the country and plays a vital role in our success. We go beyond merely providing a remote work option; we support and embrace it. We offer opportunities to make a difference from anywhere in the U.S. and enjoy better work-life balance. An annual stipend gives you the freedom to enhance your workspace with options that suit your needs.