Anonymous Company
A company is looking for a Medical Reviewer IV – Team Lead Managed Care Project (MCP) – REMOTE. Key Responsibilities: Analyze and conduct medical review investigations in accordance with UPIC policies Develop review criteria for claims and provide expert testimony as needed Train and mentor
Job Summary
A company is looking for a Medical Reviewer IV – Team Lead Managed Care Project (MCP) – REMOTE.
Key Responsibilities:
- Analyze and conduct medical review investigations in accordance with UPIC policies
- Develop review criteria for claims and provide expert testimony as needed
- Train and mentor new medical reviewers and assist in quality reviews
Required Qualifications:
- Bachelor’s Degree with active state licensure or graduate from an accredited RN school
- Minimum of 2 years in Medical Review at ZPIC or UPIC level or in a state Medicaid program
- No adverse actions pending or taken against by any State or Federal licensing board
- No conflict of interest as defined in the Social Security Act