Medical Review Manager

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Saratoga Medical has an immediate opening for a Medical Review Manager for a program supporting the Centers for Medicare and Medicaid Services (CMS) in Catonsville, MD. The work hours are Monday to Friday from 8:30 am to 5:00 pm.

Qualifications:

• Board Certified in Nursing and licensed to practice nursing in the U.S. and a currently licensed RN
• Minimum of five years of experience practicing as an RN in either an acute hospital, skilled nursing facility, or an office/clinic-based medical practice
• Minimum of two years of experience of supervisory experience with Medicare's program coverage and payment rules
• Experience in MR processes of Medicare Administrative Contractors (MACs), CERT, Supplemental Medical Review Contractor (SMRC), or Railroad Retirement Board (RRB) MAC is preferred

Responsibilities:

• Supervise the Nurse Review staff
• Development, oversight, and implementation of the CERT accuracy medical review processes while supervising the medical review nurses
• Collaborate with the Program Manager, CMD, and other contract staff

Saratoga Medical Center, Inc. is an equal opportunity employer and will not discriminate in recruiting, hiring, training, promotion, transfer, discharge, compensation or any other term or condition of employment on the basis of race, religion, color, age (over age 39), sex, national origin, or on the basis of disability if the employee can perform the essential functions of the job, with a reasonable accommodation if necessary.

Seniority level

• Seniority level
  
  Mid-Senior level

Employment type

• Employment type
  
  Full-time

Job function

• Job function
  
  Health Care Provider
• Industries Hospitals and Health Care

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