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.
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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.
Medical Review Associate Investigator
Bloomington, MN ยท On-site
Medical
Retirement
The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and ... Strong communication and stakeholder management skills. * Proficient in drafting detailed and ...
Medical Review Associate Investigator
Bloomington, MN ยท On-site
Medical
Retirement
The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and ... Strong communication and stakeholder management skills. * Proficient in drafting detailed and ...
Medical Review Associate Investigator
Bloomington, MN ยท On-site
Medical
Retirement
The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and ... Strong communication and stakeholder management skills. * Proficient in drafting detailed and ...
Medical Review Associate Investigator
Bloomington, MN ยท On-site
Medical
Retirement
The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and ... Strong communication and stakeholder management skills. * Proficient in drafting detailed and ...
Medical Review Associate Investigator
Medical
Retirement
The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and ... Strong communication and stakeholder management skills. * Proficient in drafting detailed and ...
Medical Review Associate Investigator
Medical
Retirement
The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and ... Strong communication and stakeholder management skills. * Proficient in drafting detailed and ...
Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)
Tennessee, IL ยท On-site +1
Medical
Dental
Vision
Life
Retirement
PTO
Manages and oversees the accurate processing of claims deferred for medical necessity review, ensuring adherence to nationally recognized standards as well as local, state, and federal regulations.
Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)
Tennessee, IL ยท On-site +1
Medical
Dental
Vision
Life
Retirement
PTO
Manages and oversees the accurate processing of claims deferred for medical necessity review, ensuring adherence to nationally recognized standards as well as local, state, and federal regulations.
Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)
Tennessee, IL ยท On-site +1
Medical
Dental
Vision
Life
Retirement
PTO
Manages and oversees the accurate processing of claims deferred for medical necessity review, ensuring adherence to nationally recognized standards as well as local, state, and federal regulations.
Manager, Medical Review (Medicare - Appeals; Utilization Review; Part A; HHH)
Tennessee, IL ยท On-site +1
Medical
Dental
Vision
Life
Retirement
PTO
Manages and oversees the accurate processing of claims deferred for medical necessity review, ensuring adherence to nationally recognized standards as well as local, state, and federal regulations.
Medical Review Associate Investigator
Bloomington, MN ยท On-site
$29.57 - $44.35/hr
Medical
Retirement
The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and ... Strong communication and stakeholder management skills. * Proficient in drafting detailed and ...
Medical Review Associate Investigator
Bloomington, MN ยท On-site
$29.57 - $44.35/hr
Medical
Retirement
The Medical Review Associate Investigator is part of the Special Investigations Unit (SIU) team and ... Strong communication and stakeholder management skills. * Proficient in drafting detailed and ...
Medical Review RN
Washington, DC ยท On-site
LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam ...
Medical Review RN
Washington, DC ยท On-site
LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam ...
Medical Review RN
Washington, DC ยท On-site
$45/hr
LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam ...
Medical Review RN
Washington, DC ยท On-site
$45/hr
LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam ...
LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam ...
LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam ...
Medical Review Officer (MRO)
Medical
Retirement
Leads and supports the management of physicians and cross-functional support staff within Medical Affairs, delivering occupational medicine and drug testing services. * Reviews and interprets drug ...
Medical Review Officer (MRO)
Medical
Retirement
Leads and supports the management of physicians and cross-functional support staff within Medical Affairs, delivering occupational medicine and drug testing services. * Reviews and interprets drug ...
Medical Review Officer (MRO)
Kansas City, KS ยท On-site
Medical
Retirement
Leads and supports the management of physicians and cross-functional support staff within Medical Affairs, delivering occupational medicine and drug testing services. * Reviews and interprets drug ...
Medical Review Officer (MRO)
Kansas City, KS ยท On-site
Medical
Retirement
Leads and supports the management of physicians and cross-functional support staff within Medical Affairs, delivering occupational medicine and drug testing services. * Reviews and interprets drug ...
Clinical Medical Review Nurse
Baltimore, MD ยท On-site
$36.49 - $41.49/hr
Experience in case management, discharge planning, or utilization review. Strong understanding of clinical practices and medical policy application. Proficiency in Microsoft Office (Excel, Word ...
Clinical Medical Review Nurse
Baltimore, MD ยท On-site
$36.49 - $41.49/hr
Experience in case management, discharge planning, or utilization review. Strong understanding of clinical practices and medical policy application. Proficiency in Microsoft Office (Excel, Word ...
Medical Review Nurse (USACE)
Cape Canaveral, FL ยท On-site
$66K - $70K/yr
Under general supervision of the Program Manager (PM) and reporting to the PM, the Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam ...
Medical Review Nurse (USACE)
Cape Canaveral, FL ยท On-site
$66K - $70K/yr
Under general supervision of the Program Manager (PM) and reporting to the PM, the Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam ...
Independent Medical Review Analyst
Sacramento, CA ยท On-site
$6.0K - $7.5K/mo
Independent Medical Review Analyst Classification: ANALYST II $6,031.00 - $7,547.00 A New to State ... Permanent, Full Time Department Information The mission of the Department of Managed Health Care ...
New
Independent Medical Review Analyst
Sacramento, CA ยท On-site
$6.0K - $7.5K/mo
Independent Medical Review Analyst Classification: ANALYST II $6,031.00 - $7,547.00 A New to State ... Permanent, Full Time Department Information The mission of the Department of Managed Health Care ...
New
Registered Nurse - Medical Review Specialist
Springfield, VA ยท On-site
$45 - $50/hr
Minimum of 3 years of occupational health, employee health, case management, or related nursing experience preferred * U.S. Citizenship required * Experience reviewing medical documentation and ...
Registered Nurse - Medical Review Specialist
Springfield, VA ยท On-site
$45 - $50/hr
Minimum of 3 years of occupational health, employee health, case management, or related nursing experience preferred * U.S. Citizenship required * Experience reviewing medical documentation and ...
Medical Review Nurse- Medicaid
$66K - $106K/yr
Ability to apply Federal, State and Managed Care Organization (MCO) regulations to claims under ... Experience in reviewing claims for technical requirements, performing medical review, and/or ...
Medical Review Nurse- Medicaid
$66K - $106K/yr
Ability to apply Federal, State and Managed Care Organization (MCO) regulations to claims under ... Experience in reviewing claims for technical requirements, performing medical review, and/or ...
Utilization Review Medical Appeals Nurse - USRN NTT DATA Services is currently seeking a ... Knowledge of utilization management process * Knowledge of NCQA, Medicaid regulations * Good ...
Utilization Review Medical Appeals Nurse - USRN NTT DATA Services is currently seeking a ... Knowledge of utilization management process * Knowledge of NCQA, Medicaid regulations * Good ...
As a Medical Review Specialist III (Medical Reviewer III) for Empower AI Company, you will perform ... Ensuring departmental compliance with quality managements system and ISO requirements.
As a Medical Review Specialist III (Medical Reviewer III) for Empower AI Company, you will perform ... Ensuring departmental compliance with quality managements system and ISO requirements.
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?
What does a medical review manager do?
What are the key skills and qualifications needed to thrive as a medical review manager?
What are the typical challenges faced by a medical review manager when collaborating with cross-functional teams?
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.
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The top searched job categories for Medical Review Manager jobs are:
Associate Director, Medical Review Lead, MSRM
Cambridge, MA โข On-site, Remote
Full-time
Re-posted 11 days ago
Job description
Associate Director, Medical Review Lead, MSRM
Who we are:
At Agios, we are fueled by connections to transform rare diseases. We foster an inclusive, collaborative culture - one that sparks bold thinking and strengthens our connections with each other and with the rare disease communities we serve. We embrace diverse backgrounds with respect, active listening, and a commitment to inclusion - because our differences shape how we hire, collaborate, and innovate. Our team's proven track record of executional excellence, combined with our depth of expertise and dedication, enables us to develop innovative medicines that reflect the priorities of rare disease communities. Our commitment is more than scientific - it's deeply personal, grounded in the meaningful connections we have built.ย To learn more, visitย www.agios.comย and follow Agios on LinkedIn and X.
The impact you will make:
Agios Pharmaceuticals is seeking an Associate Director,ย Medical Review Leadย to join the Medical Risk Management organization within Medical Safety & Risk Management (MSRM).
This role provides oversight of medical review for Individual Case Safety Reports (ICSRs) across investigational and marketed products, ensuring medical accuracy, regulatory compliance, and high-quality safety data to support pharmacovigilance and risk management activities.
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, Pharmacovigilance Operations, and external vendors. This role bridges ICSR medical review and case processing with broader safety surveillance and risk management activities across the product lifecycle.
The successful candidate will work cross-functionally and externally to ensure alignment with company policies, contractual obligations, and global regulatory requirements. This role requires strong medical and operational expertise in case processing and medical review, as well as the ability to effectively guide and oversee vendor performance in a dynamic and evolving environment.
What you will do
- Serve as the primary MSRM point of contact for ICSR medical review, partnering with Global Safety Leads, PV Operations, and vendors to ensure high-quality, compliant safety case assessment.
- Provide medical oversight of ICSR review for investigational and marketed products, ensuring accuracy, consistency, and scientific rigor of medical assessments.
- Review and approve key medical components of ICSRs, including narratives, coding, seriousness, expectedness, and company causality, based on source documentation.
- Perform and oversee quality control (QC) of medical review activities, providing feedback and driving vendor accountability to quality and performance standards.
- Ensure timely and compliant review of ICSR to ensure, including performing medical review activities directly when needed.
- Partner cross-functionally to support safety surveillance, risk management activities, and development of clinical and regulatory documents.
- Contribute to operational excellence through KPI/KQI monitoring, SOP development, training, and participation in system and process improvement.
- Support inspection readiness by identifying quality issues, contributing to CAPAs, and representing MSRM for medical review and case management activities.
What you bring:
- MD/DO with a minimum of 3 years of relevant drug safety/pharmacovigilance Medical Review experience.
- Minimum 1-2 years of vendor oversight in the biotechnology / pharmaceutical industry.
- Expertise with MedDRA and WhoDD dictionary coding.
- Expertise with software-based drug safety systems (ARGUS, ARISg, or equivalent)
- Solid understanding of expedited safety reporting.
- Solid knowledge of ICH and global regulations for clinical development and post-market activities pertaining to safety data collection, processing and reporting.
- Excellent communication and interpersonal skills including the ability to interact effectively and collaboratively in cross-functional teams.
- Excellent written and spoken English.
- Strong computer skills (MS Office).
- Ability to successfully prioritize and multi-task.
Concerned that you don't check off every box in the requirements listed above? Please apply anyway! At Agios, we value each other's differences and recognize that teams thrive when everyone brings their unique experiences to the table. We are dedicated to building an inclusive, diverse, equitable, and accessible environment where all employees can bring their whole selves to work. If you're excited about this role but your previous experience doesn't align perfectly with the job description, we still encourage you to apply. You may be just the right candidate for this role or another opening!
Work Location:
Location Agnostic: Work location for this role is based on employee's individual preference. This role has the ability to be either remote in the US or hybrid in our Cambridge Headquarters. Hybrid schedules vary but are generally less than 3 days per week onsite and hybrid employees are expected to live within commutable distance to our Cambridge Headquarters. Remote employees work entirely from home except for attending Company sponsored events/ meetings. For employees who choose to work remotely, travel may be required for certain company events commensurate to the above job description.
What we will give you:
- Deliberate Development. Your professional growth as one of our top priorities.
- Flexibility. We're all about individual needs. We embrace different perspectives, work styles, health and wellness approaches, care of families and productivity. When you're at your best, we're at our best.
- Premium benefits package. We invest in the health, wellbeing, and security of our people with a premium benefits package that is well-rounded and flexible to help meet the varied personal and professional needs of every member of our team. For more detail on the benefits we offer at Agios, visit the Inside Agios section of our website.
- Competitive and equitable performance-based compensation. This includes base salary and both short- and long-term incentives that are connected to our business strategy and vary based on individual and company performance.
- The current base salary range for this position is expected to be between $185,369 and $308,948 annualized; final salary will be determined based on various factors including, but not limited to, years of relevant experience, job knowledge, skills and proficiency, degree/education, and internal comparators.
- Psychological safety. We support an environment of fearlessness. We want you to share your ideas, speak candidly and take data-informed risks to help push the boundaries.
- Commitment to diversity. We strive to foster a welcoming workplace where everyone can thrive. We're continuously looking to improve the inclusivity of our workforce.
- Commitment to community. We're an active participant in the communities that surround us - the communities where we live, and the community of people and their loved ones in need of better treatment options for conditions that are often overlooked.
Interested in learning more about what makes our culture unique? Visit the Inside Agios section of our website.
Employment Type: Full timeAbout Agios Pharmaceuticals
Sourced by ZipRecruiter
Industry
Pharmaceutical and medicine manufacturing
Company size
201 - 500 Employees
Headquarters location
Cambridge, MA, US
Year founded
2008