Clinical Medical Review Nurse. Location: Baltimore, MD. Purpose: * The Clinical Medical Review ... Experience: * 3 years acute clinical experience, previous case management, discharge planning or ...
Clinical Medical Review Nurse. Location: Baltimore, MD. Purpose: * The Clinical Medical Review ... Experience: * 3 years acute clinical experience, previous case management, discharge planning or ...
Medical Review Nurse
Conshohocken, PA · Remote
Medical Review Nurse Carbon Stop Loss Solutions is a leading managing general underwriter (MGU) in the field of employer stop loss and managed care insurance. Carbon's team of experts are known as ...
Medical Review Nurse
Conshohocken, PA · Remote
Medical Review Nurse Carbon Stop Loss Solutions is a leading managing general underwriter (MGU) in the field of employer stop loss and managed care insurance. Carbon's team of experts are known as ...
Review medical documentation for medical necessity utilizing clinical knowledge and Center for ... Organization and time management skills * Knowledge of and ability to use Microsoft Excel and word ...
Review medical documentation for medical necessity utilizing clinical knowledge and Center for ... Organization and time management skills * Knowledge of and ability to use Microsoft Excel and word ...
About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide.
Quick apply
About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide.
Review medical documentation for medical necessity utilizing clinical knowledge and Center for ... Organization and time management skills * Knowledge of and ability to use Microsoft Excel and word ...
Review medical documentation for medical necessity utilizing clinical knowledge and Center for ... Organization and time management skills * Knowledge of and ability to use Microsoft Excel and word ...
Medical Review Specialist V
Henrico, VA · On-site
Review medical documentation for medical necessity utilizing clinical knowledge and Center for ... Organization and time management skills * Knowledge of and ability to use Microsoft Excel and word ...
Medical Review Specialist V
Henrico, VA · On-site
Review medical documentation for medical necessity utilizing clinical knowledge and Center for ... Organization and time management skills * Knowledge of and ability to use Microsoft Excel and word ...
The Utilization Review Manager (URM) is responsible for coordinating and monitoring clinical documentation and service authorizations to ensure medical necessity, regulatory compliance, and optimal ...
The Utilization Review Manager (URM) is responsible for coordinating and monitoring clinical documentation and service authorizations to ensure medical necessity, regulatory compliance, and optimal ...
Medical Review Specialist V
Henrico, VA · On-site
Review medical documentation for medical necessity utilizing clinical knowledge and Center for ... Organization and time management skills * Knowledge of and ability to use Microsoft Excel and word ...
Medical Review Specialist V
Henrico, VA · On-site
Review medical documentation for medical necessity utilizing clinical knowledge and Center for ... Organization and time management skills * Knowledge of and ability to use Microsoft Excel and word ...
PROJECT REVIEW MANAGER
Springfield, IL · On-site
$8.3K - $10K/mo
PROJECT REVIEW MANAGER - 88025 Office: Assistant Director's Office Division: Boards & Commissions ... Optional pre-tax programs -Medical Care Assistance Plan (MCAP) & Dependent Care Assistant Plan ...
PROJECT REVIEW MANAGER
Springfield, IL · On-site
$8.3K - $10K/mo
PROJECT REVIEW MANAGER - 88025 Office: Assistant Director's Office Division: Boards & Commissions ... Optional pre-tax programs -Medical Care Assistance Plan (MCAP) & Dependent Care Assistant Plan ...
Administrative Assistant - Medical Review Support
Atlanta, GA · On-site
$17.75 - $23.25/hr
Manage travel arrangements * Assist with office relocations when required * Create and track project correspondence * Perform additional administrative assignments as directed Medical Review Support
Quick apply
Administrative Assistant - Medical Review Support
Atlanta, GA · On-site
$17.75 - $23.25/hr
Manage travel arrangements * Assist with office relocations when required * Create and track project correspondence * Perform additional administrative assignments as directed Medical Review Support
Leads and manages global medical review and provide medical oversight for outsourced medical review activities. * Ensures medical assessment of individual case safety reports meets highest standards ...
Leads and manages global medical review and provide medical oversight for outsourced medical review activities. * Ensures medical assessment of individual case safety reports meets highest standards ...
Leads and manages global medical review and provide medical oversight for outsourced medical review activities. * Ensures medical assessment of individual case safety reports meets highest standards ...
Leads and manages global medical review and provide medical oversight for outsourced medical review activities. * Ensures medical assessment of individual case safety reports meets highest standards ...
PROJECT REVIEW MANAGER
Springfield, IL · Hybrid
$8.3K - $10K/mo
PROJECT REVIEW MANAGER - 88025 Office: Assistant Director's Office Division: Boards & Commissions ... Optional pre-tax programs -Medical Care Assistance Plan (MCAP) & Dependent Care Assistant Plan ...
PROJECT REVIEW MANAGER
Springfield, IL · Hybrid
$8.3K - $10K/mo
PROJECT REVIEW MANAGER - 88025 Office: Assistant Director's Office Division: Boards & Commissions ... Optional pre-tax programs -Medical Care Assistance Plan (MCAP) & Dependent Care Assistant Plan ...
Document Review Manager
$103K - $206K/yr
Supervise team members and manage resource allocation for document review engagements. * Advise ... Our Total Rewards package includes a variety of medical and dental plans, vision coverage ...
Document Review Manager
$103K - $206K/yr
Supervise team members and manage resource allocation for document review engagements. * Advise ... Our Total Rewards package includes a variety of medical and dental plans, vision coverage ...
About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide.
Quick apply
About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide.
Reporting to the Sr. Director, Head of Medical Risk Management, the Medical Review Lead serves as the primary point of contact for medical review and partners closely with Global Safety Leads ...
Reporting to the Sr. Director, Head of Medical Risk Management, the Medical Review Lead serves as the primary point of contact for medical review and partners closely with Global Safety Leads ...
About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide.
Quick apply
About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited Independent Review Organization (IRO) that provides objective, evidence-based medical peer reviews nationwide.
PROJECT REVIEW MANAGER
Springfield, IL · Hybrid
$8.3K - $10K/mo
PROJECT REVIEW MANAGER - 88025 Office: Assistant Director's Office Division: Boards & Commissions ... Optional pre-tax programs -Medical Care Assistance Plan (MCAP) & Dependent Care Assistant Plan ...
PROJECT REVIEW MANAGER
Springfield, IL · Hybrid
$8.3K - $10K/mo
PROJECT REVIEW MANAGER - 88025 Office: Assistant Director's Office Division: Boards & Commissions ... Optional pre-tax programs -Medical Care Assistance Plan (MCAP) & Dependent Care Assistant Plan ...
Responsibilities Benefit Highlights: · Excellent Medical, Dental, Vision and Prescription Drug ... Review Manager. Position Description: The Utilization Manager is responsible for directing and ...
Responsibilities Benefit Highlights: · Excellent Medical, Dental, Vision and Prescription Drug ... Review Manager. Position Description: The Utilization Manager is responsible for directing and ...
Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime For over 60 ... Excellent Medical, Dental, Vision and Prescription Drug Plans * 401(K) with company match and ...
Responsibilities Utilization Review Manager (URM) Position: Full-Time Shift: Daytime For over 60 ... Excellent Medical, Dental, Vision and Prescription Drug Plans * 401(K) with company match and ...
Medical Review Manager information
See salary details
$14.66 - $20.06
7% of jobs
$20.06 - $25.46
6% of jobs
$28.36 is the 25th percentile. Wages below this are outliers.
$25.46 - $30.86
21% of jobs
$30.86 - $36.25
14% of jobs
The median wage is $37.87 / hr.
$36.25 - $41.65
5% of jobs
$41.65 - $47.05
11% of jobs
$47.05 - $52.45
6% of jobs
$55 is the 75th percentile. Wages above this are outliers.
$52.45 - $57.85
9% of jobs
$57.85 - $63.24
4% of jobs
$63.24 - $68.64
6% of jobs
$68.64 - $74.04
9% of jobs
$14
$44
$74
How much do medical review manager jobs pay per hour?
As of Jul 8, 2026, the average hourly pay for medical review manager in the United States is $44.26, according to ZipRecruiter salary data. Most workers in this role earn between $28.85 and $57.69 per hour, depending on experience, location, and employer.
How to become a medical reviewer?
To become a medical reviewer, typically a healthcare professional such as a physician, nurse, or pharmacist with clinical experience is required. Candidates often need a valid medical license, relevant certifications, and familiarity with medical records and insurance policies. Gaining experience in medical documentation, coding, or claims review can also be beneficial.
Is being a MOA a good entry level job?
A Medical Office Assistant (MOA) role is often considered an entry-level position in healthcare, requiring basic administrative and clinical skills. It provides experience in medical environments and can serve as a stepping stone to more advanced healthcare roles, but it may involve repetitive tasks and limited responsibilities initially.
What does a Medical Review Manager do?
A Medical Review Manager oversees the evaluation of medical information, typically within clinical trials or insurance contexts, to ensure compliance with regulations and company standards. They lead teams that review medical documents, patient records, or clinical data to assess safety, efficacy, and adherence to protocols. Additionally, they collaborate with medical professionals, regulatory bodies, and other departments to resolve issues and improve review processes. Their role is crucial in maintaining the quality and accuracy of medical assessments and supporting organizational goals.
What is the difference between Medical Review Manager vs Medical Reviewer?
| Aspect | Medical Review Manager | Medical Reviewer |
|---|---|---|
| Certifications | Medical license, possibly additional certifications in clinical review | Medical license, often with specific clinical review certifications |
| Work Environment | Oversees review teams, manages processes, and ensures compliance | Performs clinical reviews, evaluates medical records and claims |
| Employer & Industry Usage | Insurance companies, healthcare organizations, government agencies | Insurance companies, healthcare providers, third-party review organizations |
The Medical Review Manager typically supervises review teams and manages review processes, requiring leadership skills and extensive clinical knowledge. In contrast, the Medical Reviewer focuses on conducting detailed medical evaluations and assessments. Both roles require medical licensure and clinical expertise, but the Manager has additional responsibilities in oversight and process management.
What are the key skills and qualifications needed to thrive as a Medical Review Manager, and why are they important?
To thrive as a Medical Review Manager, you need a solid background in healthcare or life sciences, experience in clinical or medical review, and often a relevant degree such as RN, MD, or PharmD. Familiarity with regulatory guidelines, medical coding systems, and tools like MedDRA or clinical trial management software is typically required. Strong analytical thinking, attention to detail, and effective communication are essential soft skills for success in this role. These competencies ensure accurate medical evaluations, regulatory compliance, and seamless collaboration with cross-functional teams.
What is the highest paying job in healthcare management?
In healthcare management, the highest paying roles are typically executive positions such as Chief Executive Officer (CEO) or Chief Operating Officer (COO) of large healthcare organizations, with salaries often exceeding $200,000 annually. These roles require extensive experience, strong leadership skills, and often advanced degrees like an MBA or healthcare administration certification.
What skills do you need to be a medical reviewer?
A medical review manager needs strong clinical knowledge, attention to detail, and the ability to interpret medical records and documentation accurately. Excellent communication skills, familiarity with healthcare regulations, and proficiency with medical review tools or software are also important. Certifications such as a medical license or relevant credentials can enhance qualifications for this role.
What are the typical challenges faced by a Medical Review Manager when collaborating with cross-functional teams?
Medical Review Managers often collaborate with clinical, regulatory, and safety teams, which can present challenges such as aligning differing priorities and timelines. Effective communication and strong organizational skills are crucial to ensure that all stakeholders are updated and that the review process runs smoothly. Navigating complex regulatory requirements and integrating feedback from multiple departments can also require adaptability and diplomatic problem-solving. Building strong relationships across teams helps streamline workflows and supports successful project outcomes.
What cities are hiring for Medical Review Manager jobs? Cities with the most Medical Review Manager job openings:
What are the most commonly searched types of Medical Review jobs? The most popular types of Medical Review jobs are:
What states have the most Medical Review Manager jobs? States with the most job openings for Medical Review Manager jobs include:
Job description
Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team. Job Title: Clinical Medical Review Nurse. Location: Baltimore, MD. Job Description: Purpose:
Preferred Qualifications:
- The Clinical Medical Review Nurse handles day-to-day review of professional and institutional claims and provider appeals that require medical review to determine if the claim is eligible for benefits and to support claims processing and/or adjudication.
- The incumbent will handle pre and post claim medical review for Commercial, FEP and Medicare Advantage Plans.
- This position assists in determining acceptable medical risk to the organization by analyzing medical information of applicants for enrollment in specific policies.
- This role will also understand the merits of legal or accreditation actions.
- 35% Receives, research, reviews and analyzes professional and institutional claims using critical thinking, nursing clinical judgment and corporate/medical policies for claims processing and/or adjudication, performs high-level research on topics identified as actual or potential medical policies. Assesses and communicates impact of information on medical policy.
- 25% Provides pricing of procedure codes which require individual consideration or are listed as "not otherwise classified" in CPT manual. Interprets the descriptive or medical information utilizing the CPT and HCPCS manuals. Keeps up to date on coding rules and standards.
- 25% Participates in medical policy meetings, nurses' forums, and review sessions with Medical and Dental directors, special projects and task forces committees as assigned.
- 15% Performs medical underwriting and risk assessment by reviewing applications of potential subscribers, as well as any appropriate medical records.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
- The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- Ability to effectively communicate and provide positive customer service to every internal and external customer, Proficient.
- Strong interpersonal skills. Ability to work independently, as well as a member of a team, Advanced.
- Current knowledge of clinical practices and related medical policies., Proficient.
- Strong organizational skills, ability to prioritize responsibilities with attention to detail., Proficient.
- Experience in using Microsoft Office (Excel, Word, Power Point, etc.) and web-based technology., Proficient.
- Must possess excellent verbal and written communication skills. Advanced.
- Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.
- Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
- Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Preferred Qualifications:
- Bachelor's degree in nursing.
- 3 years acute clinical experience, previous case management, discharge planning or utilization review experience.
- RN - Registered Nurse - State Licensure And/or Compact State Licensure RN-VA, DC and or MD Upon Hire required.
About Ampcus
Sourced by ZipRecruiter
Ampcus Inc. is a ISO 20000, ISO 27000, ISO 9001, CMMI DEV/3 SM and CMMI SVC/3 SM certified global provider of a broad range of Technology and Business consulting services. From strategy to execution, our disciplined yet flexible approach starts and ends with our clients. By listening hard and working harder, client goals become our goals. Their success is our satisfaction. It’s why our clients sleep well at night. We believe that the success of an engagement is determined by strong project management, as well as clear communication and mutual commitment working collaboratively. Our methodology begins with listening to the customer about their needs, then working with their team to gain a clear understanding of the requirements, while providing knowledge transfer of best practices for the organization.
Industry
It services
Company size
1,001 - 5,000 Employees
Headquarters location
Chantilly, VA, US
Year founded
2004