Ohio Licensed Medical Reviewer IV
Company: VirtualVocations
Location: Fayetteville
Posted on: February 1, 2025
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Job Description:
A company is looking for a Medical Reviewer IV - Team Lead
Managed Care Project (MCP).
Key Responsibilities
Analyze and conduct medical review investigations and data reviews
in accordance with UPIC policies
Develop review criteria based on Medicaid laws, rules, and
regulations
Mentor and train new medical reviewers while conducting in-depth
claim reviews
Required Qualifications, Training, and Education
Bachelor's Degree with active state licensure or equivalent related
experience
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 any State or Federal
licensing board
Strong leadership and teaching skills
Ability to manage sensitive and confidential material
Keywords: VirtualVocations, Wilmington , Ohio Licensed Medical Reviewer IV, Healthcare , Fayetteville, North Carolina
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