About this role
Medical Review Manager-Program Integrity ( RN, BSN, or MSN required ) at Commence. Location: United States or Virginia Beach or Arizona or Arkansas or Delaware or Florida or Georgia or Illinois or Indiana or Kansas or Kentucky or Massachusetts or Maryland or Michigan or Mississippi or Missouri or Montana or North Carolina or Nebraska or Nevada or New York or Ohio or Oklahoma or Pennsylvania or South Carolina or Tennessee or Texas or Virginia or District of Columbia or Wisconsin or West Virginia or Puerto Rico. Role: administering QA, directing reviews, managing team Requirements: Active RN licensure, 5+ years clinical and medical review experience, 3+ years management, strong knowledge of Medicare/CMS program integrity, QA experience, and ability to lead nationwide fraud-focused medical reviews. Category: Healthcare Services - Nursing Seniority: Senior Level Tools: Unified Case Management (UCM) Certifications: rn Commitment: Full Time Workplace: Remote Languages: English