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DIRECTOR, MEDICAL REVIEW

With more than 100 years of scientific expertise and a presence in more than 20 countries, Daiichi Sankyo and its 16,000 employees around the world draw upon a rich legacy of innovation and a robust pipeline of promising new medic...

CompanyBiospace
AddressBasking Ridge, NJ
CategoryHealthcare
Job typeFull time
Date Posted a week ago See detail

Director, Medical Review

Biospace

Basking Ridge, NJ

With more than 100 years of scientific expertise and a presence in more than 20 countries, Daiichi Sankyo and its 16,000 employees around the world draw upon a rich legacy of innovation and a robust pipeline of promising new medic...

a week ago seen See more...

Medical Reviewer II - RN (TX, OK, NM, MT & IL)

Hcsc

Richardson, TX

$63.9K - $80.9K a year

Registered Nurse with current, active, unrestricted Registered Nurse (RN) license in the state of operations (TX, OK, NM, MT & IL). For Compact Licensee changing permanent residence to State of Operations: you must obtain an activ...

3 weeks ago seen See more...

Remote WCRC Medical Reviewer

Maximus

Remote

$50 - $52 a day

Maximus- REMOTE. Must have Workers Compensation Experience . Must be available to review 25-30 hours per week. Supplemental Opportunity. Templates for reviewing. Flexible schedule. Active license and no history of major disciplina...

3 weeks ago seen See more...

Medical Economics (Medical Expense Review) Manager-Remote

Cvs Health

Connecticut, United States

***This role is classified as hybrid and will be filled in one of the core CVS locations of Hartford CT, Woonsocket RI, Northbrook IL, Scottsdale AZ, Irving TX, Atlanta GA, Cary NC, Concord CA, Chicago, IL, or Blue Bell, PA. Addit...

7 days ago seen See more...

Manager - Medical Promotional Review

Biospace

Plainsboro, NJ

Provide critical review of promotional pieces to ensure medical accuracy, validity and appropriateness of content in accordance with approved labeling, scientific data and relevant laws, regulations and NNI policies to support the...

a week ago seen See more...

Physician Spine Surgeon Telecommute Medical Review

Concentra Career Choice

Kansas City, KS

Meets (when required) with Concentra Physician Review Medical Director to discuss quality of care and credentialing and state licensure issues. -Medical direction shall also be provided consistent with the requirement that the phy...

4 weeks ago seen See more...

Medical Review Specialist / RN

Medwatch Llc

Remote - Florida, United States

From $61,000 a year

initial referral to Medical Director and, if unresolved,. referral to a specialist who is a peer to the attending physician. 401(k). 401(k) matching. Dental insurance. Employee assistance program. Employee discount. Flexible sched...

4 weeks ago seen See more...

Medical Review Manager (Full-time, Remote)

Integrity Management Services, Inc.

Alexandria, VA

$75.7K - $95.9K a year

Minimum three (3) years experience practicing nursing as a licensed Registered Nurse. Minimum of three (3) years experience of supervisory/managerial experience in the health insurance industry. Bachelors degree in Nursing is r...

4 weeks ago seen See more...

Associate Director, US Medical Review Committee Operations

Astrazeneca

Boston, MA

Providing oversight of US Medical Review Committee (MRC) process including maintaining system, training, management of coordinator, Standard Operating Procedures (SOPs). Assisting with project planning, development, and maintenanc...

a month ago seen See more...

Medical Review Scientist (Remote OK. Thousand Oaks, CA is best) - LPAM12532

Techdata Service Company, Llc

Remote

$65 - $70 an hour

Execute the Medical Review of ICSRs (narratives, coding, expectedness, causality and seriousness) to ensure quality reports. Produce medically accurate ICSRs reports. Execute ICSR case escalation as appropriate. Execute appropriat...

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Medical Reviewer for Retinal Opthmalogy

Maximus

Remote

$400 - $429 a week

Review and/or Virtual panel conference only, no in-person exam required. Receive and assess the review materials provided by MLRM for completeness. Compose Summary of Care and Evaluation of Care. Compose Review Document (aka WESC)...

a month ago seen See more...

Special Investigations Unit Medical Reviewer

Inland Empire Health Plan

Rancho Cucamonga, CA

CalPERS retirement. 457(b) option with a contribution match. Generous paid time off- vacation, holidays, sick. State of the art fitness center on-site. Medical Insurance with Dental and Vision. Paid life insurance for employees wi...

a month ago seen See more...

Senior Special Investigations Unit Medical Reviewer

Inland Empire Health Plan

Rancho Cucamonga, CA

CalPERS retirement. 457(b) option with a contribution match. Generous paid time off- vacation, holidays, sick. State of the art fitness center on-site. Medical Insurance with Dental and Vision. Paid life insurance for employees wi...

2 months ago seen See more...

Independent Medical Review Complaint Analyst

State Of California

Sacramento, CA

ASSOCIATE GOVERNMENTAL PROGRAM ANALYST. Job Application Package Checklist. Duty Statement. The position(s) require(s) a Background Investigation be cleared prior to being hired. Current version of the State Examination/Employment...

2 months ago seen See more...

Director, Skincare Medical Review Operations

Abbvie

Irvine, CA

$264K - $334K a year

Leads Global Medical Operations team, including Pharmacovigilance, Medical Information, and Medical Review, in executing all activities and deliverables that support pipeline and lifecycle management of existing skincare products...

2 months ago seen See more...

Medical Review Specialist/Auditor - Remote

Reviewworks

Remote

$42.3K - $53.6K a year

Reviews/audits medical bills and documentation according to guidelines, RW policies and procedures. Determines if treatment is related and necessary to the covered injury. Advises reimbursement recommendations are appropriate. Pro...

2 months ago seen See more...

Senior Medical Reviewer

Onesource Regulatory

Newark, NJ

$98.2K - $124K a year

Service provider in over 50 small to large sized companies Expertise in Consumer, HCP, Managed Care and Medical materials - digital and print. Experience in pharmaceutical, biotechnology, medical device, nutritional supplements, a...

2 months ago seen See more...

Medical Claims Review Coordinator-San Antonio, TX

Optum

San Antonio, TX

$43.9K - $55.6K a year

Research and resolve UM inventory accordingly to meet productivity and quality standards to include:. Claims reports with reconciliation needs. Information received through Right Fax. Information received through email. Or any oth...

3 weeks ago seen See more...

Manager - Medical Bill Review Operations

Alaffia Health

Remote

$90,000 - $110,000 a year

Lead and manage a team of Payment Integrity Analysts (PIAs), providing direction, guidance, and support to ensure the accurate and efficient execution of claim review processes. Monitor and evaluate team performance, conducting re...

3 weeks ago seen See more...

Clinical Claim Review RN - Medical Disability - Remote

Optum

Nashville, TN

$28.03 - $54.95 an hour

Remain up to date with the contract requirements. Use clinical judgement to ensure a clear, comprehensive, and concise exam documentation that is reflective of the patients service level conditions and in compliance to contract r...

3 weeks ago seen See more...

Senior Manager, Medical Information and Review

Acadia Pharmaceuticals Inc.

San Diego, CA

Participates in the review of promotional and medical materials to ensure medical accuracy. Maintains an understanding of product knowledge and labeling, associated disease states, relevant literature, treatment guidelines, compet...

3 weeks ago seen See more...

Remote Medical Claim Review LVN - Work PST Hours

Molina Healthcare

Long Beach, CA

$21.60 - $46.81 an hour

Performs clinical/medical reviews of retrospective Medical Claim Reviews, Medical Claims and previously denied cases, in which an appeal has been submitted, to ensure medical necessity and appropriate/accurate billing and claims p...

3 weeks ago seen See more...

Clinical Reviewer (Medical Coding Academy - COC) San Juan, PR

Optum

San Juan, PR

$64.3K - $81.4K a year

Clinical Case Reviews -75%Perform clinical review of professional (or facility) claims vs. medical records to determine if the claim is supported or unsupported.Maintain standards for productivity and accuracy. Standards are defin...

3 weeks ago seen See more...

Medical Information & Review Manager

Biospace

Lexington, MA

Other pertinent publications in the therapeutic areas as needed.Accountabilities: Develop, maintain, and provide high quality medical and scientific information, including Standard and Custom Response Letters, Clinical Dossiers,...

3 weeks ago seen See more...

Client Relationship Manager - Medical Claim/Bill Review

Alaffia Health

Remote

$90,000 - $110,000 a year

Managing a portfolio of clients to achieve operation objectives, retain revenue, and identify upsell opportunities. Understand client scope of work and serve as the client advocate when working with internal teams to ensure that c...

4 weeks ago seen See more...

COMPLEX MEDICAL CASE REVIEWER

Nyc Careers

New York, United States

$109,739 a year

Agency: HRA/DEPT OF SOCIAL SERVICES Job type: Full-time Title Classification: No exam required Conduct medical reviews and analyses claims to calculate injury related Medicaid liens pursuant to SSL-104b on cases involving Medical...

4 weeks ago seen See more...

Remote Medical Benefit Review Services Associate II

Conduent

Los Angeles, CA

$17 - $22 an hour

Review of paid claims, adjusted claims, and offset claims in the client system. Review of member eligibility, update of member eligibility. Investigates and communicates questionable situations. Documents findings from the client...

4 weeks ago seen See more...

Medical Interpreter - Not Remote. Local candidates only. Review Languages

International Translation Services Llc

Iowa, United States

From $30 an hour

International workforce. Flexible working hours. Understand and translate spoken and messages from one language to another. Sight translate written documents from one language to another. Provide people with a general introduction...

a month ago seen See more...

Quality Assurance Medical Records Reviewer

Advanced Orthopaedic Associates

Wayne, NJ

$16 - $19 an hour

Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, and the Internet. Must have adequate knowledge of medical terminology, anatomy and physiology. Must possess strong verbal a...

a month ago seen See more...

Medical Interpreter - Not Remote. Local candidates only. Review Languages

International Translation Services Llc

Des Moines, IA

From $30 an hour

International workforce. Flexible working hours. Understand and translate spoken and messages from one language to another. Sight translate written documents from one language to another. Provide people with a general introduction...

a month ago seen See more...

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What are the top cities open Medical Review jobs?

There are open Medical Review jobs in several cities including Baltimore, Fort Collins, Princeton, Fargo, Missoula, Philadelphia, Thousand Oaks, San Antonio, Elizabethtown, Salt Lake City, Washington, San Jose, Kansas City, Fairfax, Roseburg,

What companies are hiring for Medical Review jobs?

The top companies hiring now for Medical Review jobs are Allegiance Benefit Plan Mgmt., Blue Cross and Blue Shield of Kansas, City of San Diego, City of San Diego, CA, Concentra, Cotiviti, Lykos Therapeutics, MEDWATCH LLC, Noridian Healthcare Solutions - 3.4, Peraton, Roxborough Memorial Hospital,

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