Medical Review Manager

Responsibilities

We are looking to add an experienced Medical Review Manager to our team of talented professionals.

 

What you'll do:

 

The Medical Review Manager position entails providing direction and supervision to a staff of Nurses reviewing medical records and claims data to identify and research improper payment errors. Primary responsibilities include the following.

• Establish goals, objectives and plans for the unit
• Motivate staff and evaluate performance
• Set quality standards for the team
• Plan resources to address workload needs, set priorities and report unit activity
• Develop, administer, and control a budget
• Administer compensation and other corporate polices
• Recruit and develop staff
• Telework available from the contiguous United States

Qualifications

Qualifications:

• Bachelors degree & 10-12 years relevant experience
• Bachelor’s Degree in Nursing
• Current Registered Nurse Licensure
• Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) Certification
• A minimum of three years of experience practicing nursing as a licensed Registered Nurse
• A minimum of three years of supervisory/managerial experience in the health insurance industry, a utilization review firm, or another health care claims processing organization involving medical and coding reviews of a variety of medical and surgical claims from a variety of provider types
• Extensive knowledge of the Medicare program, particularly the coverage and payment rules
• Requires excellent organizational and communications skills as well as strong PC skills.
• US Citizenship required

* The position is contingent pending contract award.*

 

Peraton Overview

Peraton is a next-generation national security company that drives missions of consequence spanning the globe and extending to the farthest reaches of the galaxy. As the world’s leading mission capability integrator and transformative enterprise IT provider, we deliver trusted, highly differentiated solutions and technologies to protect our nation and allies. Peraton operates at the critical nexus between traditional and nontraditional threats across all domains: land, sea, space, air, and cyberspace. The company serves as a valued partner to essential government agencies and supports every branch of the U.S. armed forces. Each day, our employees do the can’t be done by solving the most daunting challenges facing our customers. Visit peraton.com to learn how we’re keeping people around the world safe and secure.

Target Salary Range

$104,000 - $166,000. This represents the typical salary range for this position based on experience and other factors.