A

Accenture

Advises businesses and runs their technology

Medical Review Manager

Medical, Clinical & VeterinaryConfirmed live in the last 24 hours
Full-time$98.1k - $197.4kIn-person

About the Job

Requirements

  • A minimum of 5 years of clinical experience in an acute care hospital, skilled nursing facility, or office/clinic-based medical practice.
  • A minimum of 5 years of previous medical review experience.
  • A minimum of 3 years of management experience.
  • Extensive knowledge of the Medicare program, including coverage and payment rules.
  • Extensive knowledge of medical review processes and medical terminology.
  • Extensive knowledge of the analysis and processing of Medicare claims and clinical review judgment.
  • Must be a Registered Nurse licensed in a U.S. state, the District of Columbia, Puerto Rico, or a U.S. territory.
  • A master's degree in nursing or a related field, or a bachelor's degree in nursing with required relevant experience.

Responsibilities

  • Serve as CMS’s primary point of contact for medical review program activities.
  • Collaborate with the Contractor Medical Director to manage, evaluate, and ensure the quality of all medical review projects.
  • Lead, coordinate, and oversee medical review activities in compliance with all CMS requirements.
  • Provide continuous quality oversight and ensure proper documentation, methodology, and reviewer accuracy.

About the Company

Accenture

Advises businesses and runs their technology

Accenture advises large businesses and public agencies on strategy, builds their technology systems and runs ongoing operations. Its teams connect business planning with implementation, covering areas such as cloud migration, cybersecurity and customer experience. Consultants work with clients to redesign processes, while engineers integrate software from technology partners and maintain the resulting systems for multinational organizations. Clients pay for project work or continuing services, including application support and business processes such as finance and customer service. Accenture was founded in 1989 and has its headquarters in Dublin, Ireland.

Company size
10,001+
Company stage
IPO
Headquarters
Dublin, Ireland
Founded
1989

Recently Posted Jobs

Explore more opportunities at Accenture

See more jobs