Clinical Reviewer, RN – Qualified Intellectual Disabilities
Comagine Health
full-time
Posted on:
Location Type: Remote
Location: Alabama • United States
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Salary
💰 $75,000 - $88,000 per year
About the role
- 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
- 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
- Annual stipend for workspace enhancement
- Better work-life balance
- Remote work options
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
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