Comagine Health · 22 hours ago
Internal Medicine, ER, Family Practice Med, Consultant Reviewer
United States
Full-time
Remote
Senior Level
$137/hr - $145/hr
7+ years expComagine 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, applying evidence-based medicine and sound clinical judgment.
Health CareHealth DiagnosticsHospital
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
Qualification
Required
MD or DO required
Active, current, unrestricted MD or DO license in the state of Washington or willing to obtain this
Board Certification 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)
Company
Comagine Health
Comagine Health is a healthcare consulting firm & they work collaboratively with patients, providers, payers and other stakeholders.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Marc H. Bennett
President & CEO
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