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Medical Review Support Jobs (NOW HIRING)

Empower AI Inc.

Medical Review Specialist V

Henrico, VA · On-site

This designation reflects the company's commitment to hiring and supporting active-duty and veteran employees. Responsibilities As a Medical Review Specialist V (Medical Reviewer V), you will review ...

Empower AI Inc.

Medical Review Specialist V

Henrico, VA · On-site

This designation reflects the company's commitment to hiring and supporting active-duty and veteran employees. Responsibilities As a Medical Review Specialist V (Medical Reviewer V), you will review ...

Empower AI Inc.

Medical Review Specialist V

This designation reflects the company's commitment to hiring and supporting active-duty and veteran employees. Responsibilities As a Medical Review Specialist V (Medical Reviewer V), you will review ...

Empower AI Inc.

Medical Review Specialist V

This designation reflects the company's commitment to hiring and supporting active-duty and veteran employees. Responsibilities As a Medical Review Specialist V (Medical Reviewer V), you will review ...

Empower AI Inc.

Medical Review Specialist V

This designation reflects the company's commitment to hiring and supporting active-duty and veteran employees. Responsibilities As a Medical Review Specialist V (Medical Reviewer V), you will review ...

Managed Medical Review Organization

About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited ... supported by evidence. * Follow MMRO's review templates, ensuring all required elements are ...

LifeHealth

Medical Review RN

Washington, DC · On-site

Position: Medical Review RN * Date: Start Date - TBD * Shift Time: 0800-1630 M-F * Location ... Supports marketing and sales objectives and efforts as requested. * Performs duties in a safe ...

Managed Medical Review Organization

About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited ... supported by evidence. * Follow MMRO's review templates, ensuring all required elements are ...

Managed Medical Review Organization

About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited ... supported by evidence. * Follow MMRO's review templates, ensuring all required elements are ...

RXinsider LTD.

The MRO, a licensed physician, supports the Medical Director in overseeing Toxicology - Workplace ... Reviews and interprets drug test results, including determining legitimate medical explanations in ...

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Medical Review Support information

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$29K

$45.8K

$61.5K

How much do medical review support jobs pay per year?

As of Sep 13, 2026, the average yearly pay for medical review support in the United States is $45,752.00, according to ZipRecruiter salary data. Most workers in this role earn between $40,000.00 and $51,500.00 per year, depending on experience, location, and employer.

What cities are hiring for Medical Review Support jobs?

Cities with the most Medical Review Support job openings:

What states have the most Medical Review Support jobs?

States with the most job openings for Medical Review Support jobs include:

What are popular job titles related to Medical Review Support jobs?

For Medical Review Support jobs, the most frequently searched job titles are:

Infographic showing various Medical Review Support job openings in the United States as of September 2026, with employment types broken down into 81% Full Time, 14% Part Time, and 5% Contract. Highlights an 90% In-person, 5% Hybrid, and 5% Remote job distribution, with an average salary of $45,752 per year, or $22 per hour.

Medical Reviewer (Registered Nurse) - Remote CA

West Sacramento, CA • On-site, Remote

Gainwell Technologies
Health Care and Social Assistance • 10K+ employees
Learn more about Gainwell Technologiesexternal

$70K - $100K/yr

Full-time

Medical, Life, Retirement, PTO

Posted 23 days ago

Gainwell Technologies rating

7.9

Company rating: 7.9 out of 10

Based on 84 frontline employees who took The Breakroom Quiz

Job description

It takes great medical minds to create powerful solutions that solve some of healthcare's most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you've honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you'll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.
Summary
Gainwell Technologies is seeking a Medical Reviewer (Registered Nurse) to support Medical Review Services for California healthcare programs. In this role, you will use your professional nursing experience and clinical judgment to review medical records, healthcare services, claims, and authorization requests.
Your role in our mission
  • Review and interpret medical records and clinical documentation to determine medical necessity and appropriateness of healthcare services.
  • Provide clinical review support for Treatment Authorization Requests (TARs) and other authorization activities.
  • Support medical review activities related to medical policy, claim adjudication, drug utilization review, and other healthcare program requirements as assigned.
  • Apply professional nursing principles, clinical judgment, medical policies, and established utilization guidelines when completing reviews.
  • Review medical documentation to determine whether requested services, procedures, supplies, and equipment meet applicable coverage and clinical requirements.
  • Document review findings, decisions, and supporting clinical rationale accurately and timely.
  • Determine approvals within established guidelines or refer cases to physicians or other appropriate clinical professionals when additional review is required.
  • Apply knowledge of hospital routines, medical services, medical supplies, and their appropriate clinical uses when conducting reviews.
  • Collaborate with physicians, pharmacists, nurses, and other healthcare professionals to support accurate medical review determinations.
  • Maintain current knowledge of applicable clinical criteria, medical policies, procedures, and regulatory requirements.
  • Meet established quality, accuracy, and productivity standards.

What we're looking for
  • Active and unrestricted Registered Nurse (RN) license to practice in the State of California, in good standing.
  • Minimum of two (2) years of professional nursing experience.
  • Possession of a Master's Degree in Nursing may substitute for one (1) year of the required professional nursing experience.
  • Knowledge of professional nursing principles and techniques, hospital routines, and medical supplies and their uses.
  • Training and/or certification in wound and ostomy care preferred.
  • Strong clinical judgment and ability to interpret medical records and supporting clinical documentation.
  • Experience with medical review, utilization review, medical necessity review, prior authorization, Treatment Authorization Requests (TARs), or claims review preferred.
  • Strong written and verbal communication skills.

What you should expect in this role
  • Full-time position.
  • Remote work environment.
  • Monday through Friday work schedule.
  • Work primarily from your home office while supporting Medical Review Services for California healthcare programs.
  • Spend the majority of your day reviewing medical, clinical, claim, authorization, and/or supporting documentation relevant to your area of expertise.
  • Work independently while collaborating with physicians, pharmacists, nurses, other clinical specialists, operations teams, and business partners.
  • Navigate multiple computer systems and applications to complete reviews, document findings, and support timely determinations.
  • Maintain all professional licenses, certifications, and credentials required for the position in active, unrestricted, and good-standing status, as applicable.
  • Maintain knowledge of applicable medical policies, coverage requirements, clinical standards, and regulatory guidelines.
  • Meet established quality, accuracy, productivity, and turnaround-time expectations.
  • Receive ongoing training and support related to program requirements, systems, policies, and medical review processes.

This position is being posted for pipeline purposes, and we welcome applications on an ongoing basis.
#LI-REMOTE
#LI-MA1
The pay range for this position is $70,000 - $100,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

What Gainwell Technologies employees say

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Benefits

Hours and flexibility

Workplace

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About Gainwell Technologies

Sourced by ZipRecruiter

With Health and Cost outcomes that pierce Inequities and Impact Economies, the success of our Nation’s Federal Medicaid program is inextricably tied to the Prosperity of Communities, States and the Nation as a whole. We think that deserves Respect and a Commitment from Innovators who can help those who operate within and around health and human services evolve to meet their goals. At Gainwell, that’s our Sole focus. Built across more than Five Decades, Gainwell has intentionally seized opportunities to advance its digitally enabled services to meet Agencies, Health plans and MCOs where they are on their modernization journeys and propel them into the future of Healthcare. Equally important to our Expanding Technologies and Results. We bring ideas that bring policies to life.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Irving, TX, US

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