Orthopedic Medical Reviewer - PRN - Sate of Washington

Comagine Health

Comagine Health is a national, non‑profit health‑care consulting firm that works collaboratively with patients, providers, payers, and other stakeholders to redesign and implement sustainable improvements in the health‑care system. As a trusted, neutral party we address complex health‑care delivery problems and draw upon expertise in quality improvement, care management, health information technology, analytics, and research.

We have two opportunities within Orthopedic Review: an on‑call position and a 0.5‑FTE to 1.0‑FTE position. Candidates must be board‑certified in the State of Washington.

As part of our Medical Affairs team of 30 physicians/dentists and a network of over 35 physician consultants, you will provide medical review, quality‑of‑care oversight, and consultation for various contracts with government and private‑sector benefit programs. In collaboration with clients we develop and implement review criteria to ensure patients receive evidence‑based care at the right time. In this role, you would:

• Apply clinical judgment, evidence‑based medicine, and other resources to render timely decisions on clinical peer reviews.
• Interact with attending physicians regarding potential decertification and related matters.
• Provide appropriate and timely subject‑matter expertise and other support to clinical reviewers, case managers, and consultants.
• Ensure that reviews meet standards for clarity of decision‑making and recordkeeping.

Active, current, valid, and unrestricted M.D. or D.O. license or certification in the State of Washington.

• Board certification by the American Board of Medical Specialties in Orthopedics.
• Possess the qualifications, as determined by the National Medical Director or designee, to render clinical opinions about the medical conditions, procedures, and/or treatments under review.
• Basic MS Office Suite proficiency.
• Excellent writing and communication skills.