Regional Medical Director On Call

Who is Comagine Health?

Comagine Health is a national, nonprofit, health care consulting firm. We work collaboratively with patients, providers, payers, and other stakeholders to reimagine, redesign and implement sustainable improvements in the health care system.

As a trusted, neutral party, we work in our communities to address key, complex health, and health care delivery problems. In all our engagements and initiatives, we draw upon our expertise in quality improvement, care management, health information technology, analytics, and research.

We invite our partners and communities to work with us to improve health and redesign the health care delivery system.

This position is on call and will be working within our Oregon Health Authority Contract within Care Management and Medical Affairs.

• Perform clinical peer reviews and appeals for multiple lines of business (i.e. Medicaid; Workers' Comp; Private) and/or diverse products in a regional office/location that is in a state or territory of the U.S, unless expressly allowed by state or Federal law or regulation.
• Duties vary per contractual requirements, but include recruiting and/or overseeing the activities of PPC consultants and participating in "fair hearings".
• In collaboration with Operation leadership, have accountability for contracted deliverables, oversee quality and process improvement programs, participate in client and provider relations activities, and contribute to strategic planning.

• MD / DO from an accredited educational institution.
• Expertise in Adolescent Psychiatry
• Provide expert consultation regarding adolescent psychiatry when requested by Oregon Health Authority
• Active, current, valid, and unrestricted M.D. or D.O. license or certification in a state or territory of the U.S.
• Board certification by the American Board or Medical Specialties or American Board of Osteopathic Specialties.
• Basic MS Office Suite proficiency.
• Demonstrated knowledge of CM, DM, and UM concepts and principles.

• At least 10 years of medical practice.
• At least 10 years of experience performing clinical peer reviews.
• Possesses the qualifications, as determined by the National Medical Director (or her or his designee), to render clinical opinions about the medical conditions, procedures, and/or treatments under review.
• Current, active medical practice preferred (unless contractually required).
• Experience as a medical director for a health insurance plan, QIO, or state or local agency preferred.