Jobs at Comagine Health

Supports business development growth strategies by developing proposals and grants, maintaining templates and compliance materials, managing CRM and SharePoint processes, coordinating technical solutions, providing administrative support, and creating Power BI reports and dashboards. The role also supports help desk operations, process improvements, conference materials, and training initiatives for business development systems and workflows.

Provides quality improvement consulting and technical assistance to healthcare providers, local health departments, and community organizations across rural Utah. Guides care coordination, referral workflows, data collection, performance improvement, partner onboarding, trainings, learning collaboratives, and community health initiatives. Coordinates with interdisciplinary teams and Community Health Workers while tracking activities in CRM and project management systems.

Reviews behavioral health documentation and conducts utilization management, functional needs, initial, and continued-stay assessments to determine medical necessity. Documents clinical decisions, coordinates referrals and services, consults with physician reviewers, supports audits and quality activities, and provides clinical expertise to stakeholders. The role is fully remote in Oregon but requires regional travel, active behavioral health licensure, clinical experience, personal transportation, and a valid driver’s license.

Conduct prospective, concurrent, and retrospective utilization reviews to assess medical necessity, quality, appropriateness, and cost-effectiveness of healthcare services under Alabama Medicaid criteria. Complete reviews within regulatory timelines, escalate unresolved determinations to physician advisors, coordinate administrative support, communicate with customers, prevent delays, and participate in Medicaid meetings and hearings. This is a full-time remote role requiring Alabama licensure and clinical experience.

Reviews behavioral health documentation and conducts functional needs assessments to determine medical necessity and service appropriateness. Performs utilization reviews using evidence-based criteria, documents determinations, manages referrals and follow-ups, consults with clinical reviewers, supports care coordination, and contributes to quality assurance and audits. This remote Oregon-based role requires travel for in-person assessments in the Eugene area.

Reviews behavioral health documentation and conducts functional needs, initial, and continued-stay assessments to determine medical necessity. Applies evidence-based criteria, documents utilization review decisions, coordinates referrals and services, consults with physician reviewers, and provides clinical expertise to stakeholders. Supports audits and quality activities while managing a high-volume workload. This remote Oregon-based role requires in-person travel across the Eugene region.

Reviews behavioral health documentation and conducts functional needs assessments to determine medical necessity and service appropriateness. Performs initial and continued stay utilization reviews, documents clinical determinations, consults with physician reviewers, coordinates referrals, responds to stakeholders, and supports quality audits. The role is fully remote in Oregon with travel throughout the Portland area for in-person assessments.

Supports Utah Community Care Hub planning and implementation by guiding healthcare and community partners through quality improvement, population health, care coordination, and referral workflow initiatives. Coaches organizations on data interpretation and performance improvement, develops clinical-community referral processes, facilitates trainings and learning collaboratives, supports clinic onboarding and workflow testing, and tracks activities using CRM and project management tools.

Conducts prospective, concurrent, and retrospective utilization reviews to determine medical necessity and appropriateness of healthcare services. Applies ASAM, InterQual, Milliman, and organizational criteria; reviews clinical records and treatment plans; documents determinations; consults clinicians; supports appeals, quality audits, compliance, and peer guidance. The role requires collaboration with providers and internal teams, strong clinical judgment, and an active unrestricted DC RN license.

Conduct prospective, concurrent, and retrospective utilization reviews to assess medical necessity, quality, compliance, and cost-effective care. Apply InterQual criteria and organizational policies, consult with physicians, escalate cases, answer stakeholder questions, obtain clinical information, and maintain accurate regulatory documentation. The role is fully remote and requires an active Alaska-eligible RN license, nursing education, and at least three years of direct patient-care experience.

Reviews behavioral health documentation and medical necessity, performs utilization and functional needs assessments, coordinates referrals and services, documents clinical determinations, consults with clinicians, supports audits and quality activities, and provides clinical expertise to stakeholders. The remote Oregon-based role requires active clinical licensure, direct patient care experience, reliable technology, personal transportation, and travel for regional in-person assessments.

Conduct behavioral health utilization reviews, assess medical necessity, complete functional needs assessments, and coordinate referrals for community-based services. Review clinical documentation using evidence-based criteria, document determinations, consult with clinicians, respond to stakeholders, and support quality audits. The role requires managing a high-volume workload, maintaining clinical licensure, and traveling throughout the Salem, Oregon area for in-person assessments.

Supports research and evaluation projects under supervision by developing materials, coordinating data collection, organizing documentation, recording meeting minutes, conducting surveys and interviews, and contributing to quantitative and qualitative analysis, reporting, and data visualization. The role requires strong organization, communication, attention to detail, and the ability to manage multiple projects remotely while maintaining accurate records and following established protocols.

Manages and implements applied research and evaluation projects focused on public health program improvement. Responsibilities include developing project materials, organizing documentation, supporting qualitative and quantitative analysis, preparing reports, leading project tasks, maintaining timelines, and conducting surveys, interviews, observations, site visits, and focus groups.

Provides non-clinical administrative and operational support for behavioral health programs. Responsibilities include scheduling, case setup, recipient and partner communication, complex data entry, records management, documentation tracking, reporting, and workflow improvement while ensuring privacy and regulatory compliance.

Senior Improvement Advisor leading healthcare quality and care delivery improvement initiatives across Utah. Responsibilities include applying quality improvement and implementation science, providing technical assistance and training, facilitating learning collaboratives, engaging healthcare stakeholders, managing project plans and deliverables, interpreting improvement data, mentoring colleagues, and supporting business development. The role focuses on strengthening healthcare organizations, improving outcomes, and advancing sustainable system transformation.

Supports Utah HUB operational workflows, CMS form processing, recordkeeping, communications, facility onboarding, scheduling, reporting, meeting logistics, and workflow documentation. The role begins with project coordination and administrative responsibilities and later transitions toward referral coordination. It requires strong organization, communication, follow-up, customer service, and proficiency with Excel, Outlook, and Zoom. The position is fully remote, Utah-based, and involves minimal travel.

Supervises clinical review staff conducting utilization and specialty reviews. Guides training, monitors performance, evaluates medical necessity and appropriateness, ensures compliance with clinical criteria and contract guidelines, manages personnel and targets, and supports process improvement. The role requires an active Alabama RN license, clinical experience, utilization review expertise, strong clinical judgment, and knowledge of healthcare regulations, documentation, and medical terminology.

Performs Alabama Medicaid clinical necessity reviews and Qualified Intellectual Disabilities Professional reviews. The role evaluates healthcare services against program criteria, completes reviews within regulatory timelines, escalates complex cases to physician advisors, coordinates with administrative teams, responds to customer needs, and participates in Medicaid meetings and hearings. The position is remote and requires an active Alabama RN license, nursing degree, and at least three years of direct patient-care experience.

Reviews behavioral health documentation and conducts initial and continued-stay utilization reviews to determine medical necessity. Completes functional needs assessments, documents clinical determinations, manages referrals and follow-ups, consults with physician reviewers, and supports care coordination, audits, quality activities, and stakeholder questions. The role is fully remote in Oregon but requires regional travel, clinical licensure, and experience with behavioral health and clinical documentation.