Position: Medical Review RN * Date: Start Date - TBD * Shift Time: 0800-1630 M-F * Location ... Consistently learns and applies codified state and federal regulations specific to particular ...
Position: Medical Review RN * Date: Start Date - TBD * Shift Time: 0800-1630 M-F * Location ... Consistently learns and applies codified state and federal regulations specific to particular ...
Our team of over 500 professionals brings deep expertise and a shared commitment to delivering ... all State and Federal mandated regulations/guidelines. * Perform accuracy reviews as a Special ...
Our team of over 500 professionals brings deep expertise and a shared commitment to delivering ... all State and Federal mandated regulations/guidelines. * Perform accuracy reviews as a Special ...
Medical Review Nurse- Medicaid
$66K - $106K/yr
We are looking to add a Nurse Reviewer to our SGS team of talented professionals. What you'll do ... Ability to apply Federal, State and Managed Care Organization (MCO) regulations to claims under ...
Medical Review Nurse- Medicaid
$66K - $106K/yr
We are looking to add a Nurse Reviewer to our SGS team of talented professionals. What you'll do ... Ability to apply Federal, State and Managed Care Organization (MCO) regulations to claims under ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical ... Maintain proper credentialing and state licenses and any special certifications or requirements ...
Reviews medical files and provides recommendations for utilization review, chart reviews, medical ... Maintain proper credentialing and state licenses and any special certifications or requirements ...
Medical Reviewer III (Medicare/DRG)
$28.38/hr
As a casual Medical Review Specialist III (Medicare DRG) for Empower AI, Inc., you will perform ... Must have no adverse actions pending or taken against him/her by any State or Federal licensing ...
Medical Reviewer III (Medicare/DRG)
$28.38/hr
As a casual Medical Review Specialist III (Medicare DRG) for Empower AI, Inc., you will perform ... Must have no adverse actions pending or taken against him/her by any State or Federal licensing ...
Maintain proper credentialing and state licenses and any special certifications or requirements ... reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE: Post ...
Maintain proper credentialing and state licenses and any special certifications or requirements ... reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE: Post ...
Medical Review Nurse - Clinical Validation
La Grange, KY · On-site
$7.25/hr
As a MR Nurse, you will join a team of experienced medical auditors and coders performing ... In accordance with applicable state laws, we do not inquire about salary history during the ...
Medical Review Nurse - Clinical Validation
La Grange, KY · On-site
$7.25/hr
As a MR Nurse, you will join a team of experienced medical auditors and coders performing ... In accordance with applicable state laws, we do not inquire about salary history during the ...
GPS Case Management Medical Review Therapeutic Area Leader
Indianapolis, IN · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Supervise Case Management Medical Review personnel within the therapeutic area across the global team, including physicians and scientists. * Build deep regulatory and technical expertise through ...
GPS Case Management Medical Review Therapeutic Area Leader
Indianapolis, IN · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Supervise Case Management Medical Review personnel within the therapeutic area across the global team, including physicians and scientists. * Build deep regulatory and technical expertise through ...
About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited ... S. state or territory, specifically KENTUCKY medical state license . * Board Certification:
Quick apply
About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited ... S. state or territory, specifically KENTUCKY medical state license . * Board Certification:
GPS Case Management Medical Review Therapeutic Area Leader
Medical
Dental
Vision
Life
Retirement
PTO
Supervise Case Management Medical Review personnel within the therapeutic area across the global team, including physicians and scientists. * Build deep regulatory and technical expertise through ...
GPS Case Management Medical Review Therapeutic Area Leader
Medical
Dental
Vision
Life
Retirement
PTO
Supervise Case Management Medical Review personnel within the therapeutic area across the global team, including physicians and scientists. * Build deep regulatory and technical expertise through ...
GPS Case Management Medical Review Therapeutic Area Leader
Indianapolis, IN · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Supervise Case Management Medical Review personnel within the therapeutic area across the global team, including physicians and scientists. * Build deep regulatory and technical expertise through ...
GPS Case Management Medical Review Therapeutic Area Leader
Indianapolis, IN · On-site
Medical
Dental
Vision
Life
Retirement
PTO
Supervise Case Management Medical Review personnel within the therapeutic area across the global team, including physicians and scientists. * Build deep regulatory and technical expertise through ...
Casual Medical Review Nurse (USSS)
Cape Canaveral, FL · On-site
$66K - $70K/yr
Duties and Responsibilities: • Performs medical review of incoming charts to determine if ... state and federal regulations specific to particular contract(s). • Serve as backup to other ...
Casual Medical Review Nurse (USSS)
Cape Canaveral, FL · On-site
$66K - $70K/yr
Duties and Responsibilities: • Performs medical review of incoming charts to determine if ... state and federal regulations specific to particular contract(s). • Serve as backup to other ...
Performs medical review activities pertaining to utilization review, quality assurance, and medical ... Current state medical license without restrictions. Experience treating or managing care for a ...
Performs medical review activities pertaining to utilization review, quality assurance, and medical ... Current state medical license without restrictions. Experience treating or managing care for a ...
... state regulations. MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and ...
... state regulations. MAJOR DUTIES AND RESPONSIBILITIES: • Reviews medical files and provides recommendations for utilization review, chart reviews, medical necessity, appropriateness of care and ...
Maintain proper credentialing and state licenses and any special certifications or requirements ... reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE:Post ...
Maintain proper credentialing and state licenses and any special certifications or requirements ... reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE:Post ...
The Medical Review Examiner Nurse is responsible for auditing provider and facility claims ... Experience or familiarity with state and federal regulations governing healthcare preferred.
The Medical Review Examiner Nurse is responsible for auditing provider and facility claims ... Experience or familiarity with state and federal regulations governing healthcare preferred.
Maintain proper credentialing and state licenses and any special certifications or requirements ... reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE:Post ...
Maintain proper credentialing and state licenses and any special certifications or requirements ... reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE:Post ...
As a MR Nurse Auditor, you will join a team of experienced medical auditors and coders performing ... In accordance with applicable state laws, we do not inquire about salary history during the ...
As a MR Nurse Auditor, you will join a team of experienced medical auditors and coders performing ... In accordance with applicable state laws, we do not inquire about salary history during the ...
We are a 50-state physician, registered nurse, and genetic counselor network with a strong care ... team and technology infrastructure. Our model integrates genetic counselors, physicians, and ...
We are a 50-state physician, registered nurse, and genetic counselor network with a strong care ... team and technology infrastructure. Our model integrates genetic counselors, physicians, and ...
Quality Review Coordinator
Birmingham, AL · On-site
BASIC FUNCTION Perform and administer level 2 Medical Review Pre-Determinations according to ... Perform medical and utilization predeterminations of PMD and/or non-PMD providers both in state and ...
Quality Review Coordinator
Birmingham, AL · On-site
BASIC FUNCTION Perform and administer level 2 Medical Review Pre-Determinations according to ... Perform medical and utilization predeterminations of PMD and/or non-PMD providers both in state and ...
State Medical Review Team information
See salary details
$11.78 - $19.84
14% of jobs
$24.28 is the 25th percentile. Wages below this are outliers.
$19.84 - $27.91
21% of jobs
The median wage is $32.08 / hr.
$27.91 - $35.97
30% of jobs
$35.97 - $44.03
9% of jobs
$46.72 is the 75th percentile. Wages above this are outliers.
$44.03 - $52.10
3% of jobs
$52.10 - $60.16
13% of jobs
$60.16 - $68.23
1% of jobs
$68.23 - $76.29
4% of jobs
$76.29 - $84.35
0% of jobs
$84.35 - $92.42
0% of jobs
$92.42 - $100.48
5% of jobs
$11
$42
$100
How much do state medical review team jobs pay per hour?
What is the difference between State Medical Review Team vs Medical Reviewer?
| Aspect | State Medical Review Team | Medical Reviewer |
|---|---|---|
| Credentials | Medical degree, licensure, often specialized in medical review | Medical degree, licensure, may have specialization depending on role |
| Work Environment | State agencies, government offices, reviewing claims or cases | Hospitals, insurance companies, government agencies, reviewing medical records |
| Employer & Industry | State government, public health, Medicaid/Medicare | Insurance companies, healthcare organizations, government agencies |
| Common Search/Comparison | Yes | No |
The State Medical Review Team typically consists of healthcare professionals working within state agencies to review medical claims or cases, often focusing on Medicaid or Medicare. Medical Reviewers may work in various healthcare settings, including insurance companies or hospitals, and perform similar reviews. While both roles require medical credentials, the State Medical Review Team is more associated with government-led case assessments, whereas Medical Reviewers work across different healthcare organizations.
What skills and qualifications are needed to thrive as a State Medical Review Team member?
How does the State Medical Review Team collaborate with other healthcare professionals and state agencies during the disability determination process?
What is the State Medical Review Team?
What states have the most State Medical Review Team jobs?
States with the most job openings for State Medical Review Team jobs include:
What job categories do people searching State Medical Review Team jobs look for?
The top searched job categories for State Medical Review Team jobs are:

Job description
LifeHealthLLC (LifeHealth), a professional services company specializing in worksite wellness services, clinical staffing, and healthcare readiness is looking for qualified Registered Nurses (RN) responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam components are accurate. The
RN works directly with Physicians and Examinees to ensure all medical information is gathered andperforms medical Quality Assurance on all charts in various process stages leading to a final
determination.
- Position: Medical Review RN
- Date: Start Date - TBD
- Shift Time: 0800-1630 M-F
- Location: Washington, DC
Position Summary:
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 components are accurate. The RN works directly with Physicians and Examinees to ensure all medical information is gathered and performs medical Quality Assurance on all charts in various process stages leading to a final determination.This position is temporary short-term position for 6-8 weeks with possible extension.
Essential Duties and Responsibilities include, but are not limited to the following:
- Performs medical review of incoming charts to determine if additional medical information is needed.
- Collaborates with Physician(s) and other internal nursing staff members f or chart review.
- Performs medical Quality Assurance (QA) on all charts in various process stages.
- Interfaces with Client's Medical Department as well as the on-site provider.
- Contacts Examinee via telephone or email to clarify information necessary to complete the chart.
- Develops a very good understanding of the specific contract's guidelines and addendums as required.
- Masters the various software programs specific to the functioning of the exam program.
- Implements and follows up on requests for further evaluation from the Examinee when required.
- Works closely with other departments to provide accurate and quality outcomes.
- Thoroughly cognizant of metrics and organizes workload to meet them.
- Consistently learns and applies codified state and federal regulations specific to particular contract(s).
- Serve as backup to other nurses f or daily duties and assists with follow-up calls to facilities and Examinees as needed as well as other duties as assigned.
- Opportunity to travel and assist on medical mobile events as either a site lead and/or RN as work orpersonal schedule permit.
- May participate in interdepartmental project groups or task forces to integrate activities, communicate issues, obtain approvals, resolve problems, and maintain a specif ic level of knowledge pertaining to new
developments, new task efforts, contract awards, and new policy requirements. - Supports marketing and sales objectives and efforts as requested.
- Performs duties in a safe manner. Follows the corporate safety policy. Participates and supports safety meetings, training, and goals. Ensures safe operating conditions within an area of responsibility.
Encourages co-workers to work safely. Identifies "close calls" and/or safety concerns to supervisory
personnel. Maintains a clean and orderly work area. - Assists in the active implementation of company initiatives to ensure compliance with OSHA VPP, ISO,JCAHO, AAAHC, and other mandated regulations/standards.
- May serve on the OSHA VPP, Safety, and Wellness Committees.
Qualifications/Knowledge Skills & Abilities:
- 5-7 years of relevant experience.
- Fully unencumbered nursing license to work in Washington DC required.
- Proficiency with computer and common office equipment, as well as with MS Office products.
- Must be able to multitask, be flexible, be organized, and have excellent oral and written communicationskills as well as exceptional attention to detail.
- Ability to work independently and prioritize a moderate workload with minimal supervision
- Adaptability to schedule changes on an as-need basis
- Must beeligibleto work in theUS
- Must possessreliable transportation, have a clean driving record, and current automobile insurance.
- Must be 18 years of age or older
- Current CPR,BLS or ACLS
Disclaimer:
LifeHealthis an Equal Employment Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
#IND