Clinical Reviewer, RN – Qualified Intellectual Disabilities

Comagine Health

Clinical Reviewer (RN) assessing medical necessity and performing QIDP reviews in Alabama. Working remotely to support Medicaid requirements with a focus on care quality and patient outcomes.

Posted 4/15/2026full-timeRemote • Alabama • 🇺🇸 United StatesMid-LevelSenior💰 $75,000 - $88,000 per yearWebsite

About the role

Key responsibilities & impact

Perform Clinical Review work and QIDP reviews
Apply Alabama Medicaid program criteria and guidelines
Complete reviews within timelines established by state and federal requirements
Consult with Physician Advisor/Consulting Physician for complex cases
Work with administrative support
Identify customer needs and respond timely
Attend Medicaid meetings, fair hearings, and legislative committee sessions as requested

Requirements

What you’ll need

BA/BS in Nursing
Active RN in Alabama
Minimum of 3 years of direct patient care (clinical) experience
Current, active, unrestricted RN license in Alabama
Experience with performing PA reviews
Long-term care experience including nursing home, ICF/IID, swing bed, PEC, and inpatient psychiatric facilities
Provider relations
Reporting skills

Benefits

Comp & perks

Annual stipend for workspace enhancement
Better work-life balance
Remote work options

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

clinical reviewQIDP reviewsPA reviewsdirect patient carelong-term carenursing home experienceICF/IID experienceswing bed experienceinpatient psychiatric facilities experiencereporting skills

Soft Skills

customer needs identificationtimely responseconsultationadministrative supportattendance at meetings

Certifications

BA/BS in Nursingactive RN license in Alabama