Manager, Clinical Adjudication Operations Job Requisition ID: 1581 Posting Start Date: 6/2/26 At Daiichi Sankyo, we are united by a single purpose, to improve lives around the world through ...
Manager, Clinical Adjudication Operations Job Requisition ID: 1581 Posting Start Date: 6/2/26 At Daiichi Sankyo, we are united by a single purpose, to improve lives around the world through ...
Assists with the clinical aspects of charter development; be aware of the MedDRA preferred terms listings for the protocol's indication. Responsibilities Adjudication / Endpoint Workstream Planning ...
Assists with the clinical aspects of charter development; be aware of the MedDRA preferred terms listings for the protocol's indication. Responsibilities Adjudication / Endpoint Workstream Planning ...
Supervisor (Clinical Adjudication)
Austin, TX ยท On-site +1
Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for Associate's degree on a year per year basis ...
Supervisor (Clinical Adjudication)
Austin, TX ยท On-site +1
Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for Associate's degree on a year per year basis ...
Clinical Adjudication Manager
Austin, TX ยท On-site +1
Additional clinical or medical administration experience may be substituted for Associate's degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the ...
Clinical Adjudication Manager
Austin, TX ยท On-site +1
Additional clinical or medical administration experience may be substituted for Associate's degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the ...
Supervisor (Clinical Adjudication) Weekday Evening Shift - Flexible Scheduling
Austin, TX ยท On-site +1
Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for Associate's degree on a year per year basis ...
Supervisor (Clinical Adjudication) Weekday Evening Shift - Flexible Scheduling
Austin, TX ยท On-site +1
Additional experience in Medicare appeals, medical review, clinical, or other related experience in a healthcare setting may be substituted for Associate's degree on a year per year basis ...
Clinical / Therapy - Clinical Therapist
Tuskegee, AL ยท On-site
$54K - $73K/yr
Clinical / Therapy - Clinical Therapist Overview: The Family Service Workercoordinates and delivers ... Sequel TSIof Tuskegee services adjudicated adolescents, ages 12 - 18. Qualifications: This position ...
Clinical / Therapy - Clinical Therapist
Tuskegee, AL ยท On-site
$54K - $73K/yr
Clinical / Therapy - Clinical Therapist Overview: The Family Service Workercoordinates and delivers ... Sequel TSIof Tuskegee services adjudicated adolescents, ages 12 - 18. Qualifications: This position ...
Clinical Safety Specialist
Waltham, MA ยท On-site
Ensure adjudicated endpoints and safety outcomes are accurately captured, reconciled, and reflected in post-market safety datasets, clinical databases, and downstream analyses and reports. * Support ...
Clinical Safety Specialist
Waltham, MA ยท On-site
Ensure adjudicated endpoints and safety outcomes are accurately captured, reconciled, and reflected in post-market safety datasets, clinical databases, and downstream analyses and reports. * Support ...
Clinical Adjudication Manager (Weekday Evening Shift + Flexible Scheduling (Part Time or Full Time)
Austin, TX ยท On-site +1
Additional clinical or medical administration experience may be substituted for Associate's degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the ...
Clinical Adjudication Manager (Weekday Evening Shift + Flexible Scheduling (Part Time or Full Time)
Austin, TX ยท On-site +1
Additional clinical or medical administration experience may be substituted for Associate's degree on a year per year basis. (Experience requirements may be satisfied by full-time experience or the ...
Clinical Safety Specialist
Waltham, MA ยท On-site
Manage all operational aspects of the Clinical Endpoint Adjudication Committee (CEAC),including memberonboarding, training,logistics, adjudication packet preparation, meeting coordination, and ...
Quick apply
Clinical Safety Specialist
Waltham, MA ยท On-site
Manage all operational aspects of the Clinical Endpoint Adjudication Committee (CEAC),including memberonboarding, training,logistics, adjudication packet preparation, meeting coordination, and ...
Clinical Safety Specialist
Waltham, MA ยท On-site
Manage all operational aspects of the Clinical Endpoint Adjudication Committee (CEAC),including memberonboarding, training,logistics, adjudication packet preparation, meeting coordination, and ...
Clinical Safety Specialist
Waltham, MA ยท On-site
Manage all operational aspects of the Clinical Endpoint Adjudication Committee (CEAC),including memberonboarding, training,logistics, adjudication packet preparation, meeting coordination, and ...
Senior Clinical Project Manager (Remote)
$125K - $175K/yr
Everest Clinical Research ("Everest") is a full-service contract research organization (CRO ... or adjudication committees, regulatory submissions, vendor management, and medical/scientific ...
Senior Clinical Project Manager (Remote)
$125K - $175K/yr
Everest Clinical Research ("Everest") is a full-service contract research organization (CRO ... or adjudication committees, regulatory submissions, vendor management, and medical/scientific ...
Clinical Pharmacist
$142K - $170K/yr
Help with pharmacy claims adjudication, benefit and formulary problems generated from external and ... Equivalent to two years of work in a clinical pharmacy. Managed care and drug information center ...
Clinical Pharmacist
$142K - $170K/yr
Help with pharmacy claims adjudication, benefit and formulary problems generated from external and ... Equivalent to two years of work in a clinical pharmacy. Managed care and drug information center ...
Clinical Pharmacist-Formulary
$117K - $140K/yr
... adjudication process for Prior Authorization Drug Reviews (PADRs). Learn more about this agency ... This Clinical Pharmacist will adjudicate PADRs through the performance of patient medication ...
Clinical Pharmacist-Formulary
$117K - $140K/yr
... adjudication process for Prior Authorization Drug Reviews (PADRs). Learn more about this agency ... This Clinical Pharmacist will adjudicate PADRs through the performance of patient medication ...
Clinical Pharmacist-Formulary
Phoenix, AZ ยท On-site +1
$141K - $184K/yr
... adjudication process for Prior Authorization Drug Reviews (PADRs). Learn more about this agency ... This Clinical Pharmacist will adjudicate PADRs through the performance of patient medication ...
Clinical Pharmacist-Formulary
Phoenix, AZ ยท On-site +1
$141K - $184K/yr
... adjudication process for Prior Authorization Drug Reviews (PADRs). Learn more about this agency ... This Clinical Pharmacist will adjudicate PADRs through the performance of patient medication ...
Participate in development and oversight of endpoint adjudication charters, safety monitoring plans, and Data Monitoring Committee (DMC) interactions. * Provide clinical input into data management ...
Participate in development and oversight of endpoint adjudication charters, safety monitoring plans, and Data Monitoring Committee (DMC) interactions. * Provide clinical input into data management ...
OR ยท On-site
Participate in development and oversight of endpoint adjudication charters, safety monitoring plans, and Data Monitoring Committee (DMC) interactions. * Provide clinical input into data management ...
Clinical Coding Consultant Pharmacist - Remote
Houston, TX ยท Remote
$91K - $163K/yr
Extracts, evaluates and interprets clinical coding in adjudication & formulary management systems You'll be rewarded and recognized for your performance in an environment that will challenge you and ...
Clinical Coding Consultant Pharmacist - Remote
Houston, TX ยท Remote
$91K - $163K/yr
Extracts, evaluates and interprets clinical coding in adjudication & formulary management systems You'll be rewarded and recognized for your performance in an environment that will challenge you and ...
Clinical Coding Consultant Pharmacist - Remote
Houston, TX ยท On-site +1
$91K - $163K/yr
Extracts, evaluates and interprets clinical coding in adjudication & formulary management systems You'll be rewarded and recognized for your performance in an environment that will challenge you and ...
Clinical Coding Consultant Pharmacist - Remote
Houston, TX ยท On-site +1
$91K - $163K/yr
Extracts, evaluates and interprets clinical coding in adjudication & formulary management systems You'll be rewarded and recognized for your performance in an environment that will challenge you and ...
Claims Adjudicator
Laguna Hills, CA ยท On-site
Adhere to the 14-day adjudication and scheduled delivery window. * Promptly report underpaid claims ... clinical and economic outcomes while maintaining the utmost compassion and care for our patients.
Quick apply
Claims Adjudicator
Laguna Hills, CA ยท On-site
Adhere to the 14-day adjudication and scheduled delivery window. * Promptly report underpaid claims ... clinical and economic outcomes while maintaining the utmost compassion and care for our patients.
Claims Adjudicator
$29 - $32/hr
Adhere to the 14-day adjudication and scheduled delivery window. * Promptly report underpaid claims ... clinical and economic outcomes while maintaining the utmost compassion and care for our patients.
Claims Adjudicator
$29 - $32/hr
Adhere to the 14-day adjudication and scheduled delivery window. * Promptly report underpaid claims ... clinical and economic outcomes while maintaining the utmost compassion and care for our patients.
Clinical Adjudication information
See salary details
$12.02 - $17.26
0% of jobs
$17.26 - $22.51
8% of jobs
$22.51 - $27.75
13% of jobs
$29.16 is the 25th percentile. Wages below this are outliers.
$27.75 - $33
15% of jobs
$33 - $38.24
13% of jobs
The median wage is $39.03 / hr.
$38.24 - $43.49
11% of jobs
$43.49 - $48.73
12% of jobs
$50.59 is the 75th percentile. Wages above this are outliers.
$48.73 - $53.98
13% of jobs
$53.98 - $59.22
14% of jobs
$59.22 - $64.47
2% of jobs
$64.47 - $69.71
1% of jobs
$12
$41
$69
How much do clinical adjudication jobs pay per hour?
What is the difference between Clinical Adjudication vs Medical Claims Reviewer?
| Aspect | Clinical Adjudication | Medical Claims Reviewer |
|---|---|---|
| Credentials | Certifications in healthcare, clinical knowledge | Insurance, claims processing certifications |
| Work Environment | Hospitals, healthcare facilities, insurance companies | Insurance companies, third-party administrators |
| Industry Usage | Healthcare, insurance | Insurance, healthcare |
| Job Focus | Assessing clinical validity of claims, medical necessity | Reviewing claim documentation for accuracy and compliance |
While both roles involve reviewing medical information, Clinical Adjudication focuses on determining the medical necessity and validity of claims based on clinical criteria, often requiring healthcare knowledge. Medical Claims Reviewers primarily verify documentation accuracy and compliance with insurance policies. Understanding these distinctions helps clarify career paths and employer expectations in healthcare and insurance industries.
Full-time
Posted 13 days ago
Job description
Job Requisition ID: 1581
Posting Start Date: 6/2/26
At Daiichi Sankyo, we are united by a single purpose, to improve lives around the world through innovative medicines. With a legacy of innovation since 1899, a presence in more than 30 countries, and more than 19,000 employees, we are advancing breakthrough therapies in oncology, cardiovascular disease, rare diseases, and immune disorders. Guided by our 2030 vision to "be an innovative global healthcare company contributing to the sustainable development of society", we are shaping a healthier, more hopeful future for patients, their families, and society.
Job Summary
The incumbent will be a highly competent, self-motivated individual who can support clinical research studies in all phases. The individual should possess good judgment with well-developed critical thinking and super attention to detail skills.
Required to perform tasks for projects according to timelines for the designated workflows, which may have multiple studies overlapping in the timeframe. Primary responsibility for clinical review to assure data completeness, consistency, logic and medical accuracy, patient safety and protocol compliance. Have general knowledge of clinical review of case content that includes source documents, such as procedure reports, hospitalization summaries, narratives, CIOMS, and AE coding. Provide clinical support in project meetings; Support study close out activities. Assists with the clinical aspects of charter development; be aware of the MedDRA preferred terms listings for the protocol's indication.
Job Description
Responsibilities
Adjudication / Endpoint Workstream Planning and Execution
- Ensures optimal program productivity and efficiencies.
- Become a Subject Matter Expert (SME) with the process currently in use; be able to describe to study teams and other key departments how their study will interact with the adjudication vendor;
- Describe the expectation and importance of adjudication between the vendor to the CRO;
- Become an active "extended team member" to multiple studies at the same time; Being extremely organized to discuss with studies at different timepoints.
- Working with senior management, biostats and safety physicians when prioritization of deliverables are requested.
- Preparing meaningful metrics and reports for senior leadership, as well as study teams to make them aware of urgency and/ or details; Provide updates to internal teams; reporting on critical project status, risks, escalations and achievements.
- Triage, resolve or escalate study issues to the Study Manager, Global Team Lead and CSPV.
- Read, understand and adhere to Daiichi Sankyo GSOPs related to Adjudication and Independent Review Committees.
- Contributes to Adjudication Operations team by exploring new opportunities to add value and repeat the key processes consistently.
Adjudication Committee
- Provide clinical administrative support to the committee. This may include preparing meeting agendas, and training materials to be used for new members.
- Collect documents from the members, related to general regulatory processes, i.e. CVs, financial disclosures, professional journals, etc.
- May review and oversee AC members payments requests.
Adjudication Documentation
- Provide oversight of the creation and filing of Charters, Plans, Site Manuals, Quick Reference guides; Provide insight to which documents are translated for global use, Reconcile the Adjudication documents in the TMF by compound and protocol. Identify and resolve issues with the reconciliation.
- Support analysis of study site ILD adjudication metrics reports to identify potential areas of concern, trends, missing eDC pages, issues with image uploading; bring to the attention of the Study Team / CRO; offer solutions
- Track study site start-up recruitment, enrollment, expansion into additional countries and use of replacement sites; be aware of study's milestones and timelines.
- Participate in ILD Adjudication training at Investigator Meetings, Site Initiations, global CRA trainings; make recommendations for better communication with sites and coordinators;
- Analyze reports from the electronic adjudication system, searching for outstanding query ranges; discrepancies in dates or adverse event terms.
Qualifications
Education Qualifications
- Master's degree with 3+ years of relevant experience or Bachelor's degree with 5+ years relevant experience is required
Experience Qualifications
- Knowledge of ICH/GCP and regulatory guidelines/directives preferred
- Knowledge of Adjudication process and working with adjudication committees and/or Independent Review Committees preferred
Travel Requirements
Ability to travel up to 10% of the time. Position that may require occasional travel (global).
Daiichi Sankyo, Inc. is an equal opportunity/affirmative action employer. Qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.
Salary Range:
USD$127,280.00 - USD$190,920.00
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