Comagine Health
201 - 500 employees
Founded 1973
🤝 Non-profit
🤝 B2B
🔬 Science
Non-profit • B2B • Science
Comagine Health is a national nonprofit health care consulting organization that partners with providers, payers, public agencies, community organizations and consumers to improve health care quality, equity, and outcomes. It offers systemwide quality improvement, care management, data solutions, research and evaluation, and COVID-19 response services, using health information exchange and health IT to inform public health surveillance and program design. Comagine focuses on supporting community health, behavioral health, and patient-centered initiatives through technical assistance, evaluation, and collaborative systems-level work.
Clinical Reviewer – Lead
🕒 April 16
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Comagine Health
201 - 500 employees
Founded 1973
🤝 Non-profit
🤝 B2B
🔬 Science
Non-profit • B2B • Science
Comagine Health is a national nonprofit health care consulting organization that partners with providers, payers, public agencies, community organizations and consumers to improve health care quality, equity, and outcomes. It offers systemwide quality improvement, care management, data solutions, research and evaluation, and COVID-19 response services, using health information exchange and health IT to inform public health surveillance and program design. Comagine focuses on supporting community health, behavioral health, and patient-centered initiatives through technical assistance, evaluation, and collaborative systems-level work.
📋 Description
• Lead and mentor a team of clinical reviewers, providing training, performance feedback, and professional development opportunities. • Conduct and oversee detailed clinical reviews of medical records, claims, and related documentation to ensure accuracy and compliance with established guidelines. • Collaborate with healthcare providers, auditors, and internal departments to resolve discrepancies and improve review processes. • Develop, update, and implement clinical review protocols and quality assurance measures to maintain regulatory compliance and enhance review effectiveness. • Analyze clinical data and review outcomes to identify trends, recommend improvements, and support strategic decision-making.
🎯 Requirements
• Bachelor’s degree in Nursing, Health Sciences, or a related clinical field. • Active RN licensure. • Minimum of 5 years of clinical review experience within healthcare services. • Strong knowledge of medical terminology, clinical documentation, and healthcare regulations. • Proven leadership experience managing clinical teams or projects. • Excellent analytical, communication, and organizational skills. • Master’s degree in Nursing, Healthcare Administration, or a related discipline (preferred). • Certification in Clinical Documentation Improvement (CDI) or Certified Professional Medical Auditor (CPMA) (preferred). • Experience with electronic health record (EHR) systems and clinical review software (preferred). • Familiarity with Medicare, Medicaid, and other payer regulations (preferred). • Experience working in a fast-paced healthcare environment with multidisciplinary teams (preferred).
🏖️ 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!
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