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
