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Medical Review Manager Jobs (NOW HIRING)

Empower AI Inc.

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 ...

Empower AI Inc.

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 ...

Empower AI Inc.

Medical Review Specialist V

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 ...

Memorial Physician Practices

Health (Medical, Dental, Vision) and 401K Benefits for full-time employees * Competitive Paid Time ... Interface with managed care organizations, external reviews, and other payers. * Communicate with ...

New

RXinsider LTD.

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 ...

Commence

VA · On-site

$88K - $115K/yr

Monitor team-level accuracy and quality trends; recommend corrective actions and process improvements to the Medical Review Manager * Support vulnerability identification and trend/root-cause ...

LifeHealth

Medical Review RN

Washington, DC · 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 ...

UHS

Utilization Review Manager

Grand Rapids, MI · On-site

Responsibilities Benefit Highlights: · Excellent Medical, Dental, Vision and Prescription Drug ... Review Manager. Position Description: The Utilization Manager is responsible for directing and ...

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Medical Review Manager information

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How much do medical review manager jobs pay per hour?

As of Sep 9, 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.

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 are the key skills and qualifications needed to thrive as a medical review manager?

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 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 is the difference between Medical Review Manager vs Medical Reviewer?

AspectMedical Review ManagerMedical Reviewer
CertificationsMedical license, possibly additional certifications in clinical reviewMedical license, often with specific clinical review certifications
Work EnvironmentOversees review teams, manages processes, and ensures compliancePerforms clinical reviews, evaluates medical records and claims
Employer & Industry UsageInsurance companies, healthcare organizations, government agenciesInsurance 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.

How to become a medical review manager?

To become a medical review manager, candidates typically need a medical degree such as a medical doctor (MD) or registered nurse (RN) license, along with experience in healthcare or medical claims review. Strong analytical skills, knowledge of medical coding and documentation, and familiarity with healthcare regulations are essential, and some roles may require certification such as Certified Medical Review Officer (CMRO).
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Medical Review Manager jobs near you

Clinical Medical Review Nurse

Baltimore, MD • On-site

Lumen Solutions Group Inc.
See more jobs at Lumen Solutions Group Inc.external

Other

Posted 29 days ago

Job description

Clinical Medical Review Nurse

We are seeking Licensed Practical Nurses (LPN) or Registered Nurses (RN) to join the Quality team as Clinical Medical Review Nurses. This is a hybrid contract position requiring both remote work and regular onsite presence at the Canton, MD office. Nurses will support the review and abstraction of medical records to ensure accuracy and compliance with quality standards.

Key responsibilities include:

  • Review and abstract data from medical records
  • Extract relevant clinical data using Electronic Medical Record (EMR) systems
  • Participate in periodic onsite provider visits (minimum once per month) to retrieve medical records
  • Attend mandatory in-person training in January and again in June or July
  • Use basic Excel to enter, track, and manage clinical data
  • Work collaboratively with internal QA and clinical teams

Qualifications:

  • Active RN, LPN, or Compact Nursing License (must be current and in good standing)
  • Minimum 5 years of clinical experience
  • Experience with medical record review and data abstraction
  • Proficiency with Electronic Medical Record (EMR) systems
  • Basic knowledge of Microsoft Excel
  • Must reside in the state of Maryland (MD)
  • Willingness to be onsite 2–3 days/week in Canton, MD and travel to provider offices as needed

Preferred qualifications:

  • HEDIS experience (preferred but not required)
  • Nursing degree (Associate or Bachelor's – a plus)

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