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State Medical Review Team Jobs (NOW HIRING)

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 ...

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 ...

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 ...

About MMRO Managed Medical Review Organization (MMRO) is an established, URAC-accredited ... S. state or territory, specifically KENTUCKY medical state license . * Board Certification:

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 ...

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State Medical Review Team information

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$11

$42

$100

How much do state medical review team jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for state medical review team in the United States is $42.06, according to ZipRecruiter salary data. Most workers in this role earn between $22.84 and $54.09 per hour, depending on experience, location, and employer.

What is the difference between State Medical Review Team vs Medical Reviewer?

AspectState Medical Review TeamMedical Reviewer
CredentialsMedical degree, licensure, often specialized in medical reviewMedical degree, licensure, may have specialization depending on role
Work EnvironmentState agencies, government offices, reviewing claims or casesHospitals, insurance companies, government agencies, reviewing medical records
Employer & IndustryState government, public health, Medicaid/MedicareInsurance companies, healthcare organizations, government agencies
Common Search/ComparisonYesNo

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?

To thrive as a State Medical Review Team member, you need a strong background in medicine or healthcare, typically supported by an MD, DO, RN, or related licensure, and experience in disability evaluation or case review. Familiarity with medical documentation systems, state and federal disability criteria, and electronic health records is essential. Attention to detail, critical thinking, and effective communication are key soft skills for assessing complex medical cases and collaborating with interdisciplinary teams. These skills ensure accurate, fair, and timely eligibility determinations for public health and disability benefit programs.

How does the State Medical Review Team collaborate with other healthcare professionals and state agencies during the disability determination process?

The State Medical Review Team (SMRT) frequently works with a variety of professionals, such as physicians, psychologists, social workers, and case managers, to gather comprehensive medical evidence needed for disability determinations. Team members also coordinate closely with state agencies, including social services and public health departments, to ensure timely and accurate assessments. Effective communication and collaboration are essential, as the team often consults external healthcare providers for additional records or expert opinions. This multidisciplinary approach helps maintain fairness and consistency in evaluating eligibility for state assistance programs.

What is the State Medical Review Team?

The State Medical Review Team (SMRT) is a group of medical professionals who evaluate medical evidence to determine disability status for state and federal assistance programs. They review applications to decide if an individual's medical condition meets the criteria for programs like Medicaid Disability or Social Security Disability. The SMRT's decisions help ensure that benefits are provided to those who medically qualify, based on standardized guidelines. Their work often involves collaborating with healthcare providers and reviewing detailed medical records.
More about State Medical Review Team jobs

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:

Infographic showing various State Medical Review Team job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, and 4% Contract. Highlights an 94% Physical, 2% Hybrid, and 4% Remote job distribution, with an average salary of $87,476 per year, or $42.1 per hour.

Part-time

Re-posted 11 days ago


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.

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