About this opportunity
Commence lists this Senior Medical Review & Program Integrity Lead opportunity in virginia beach, Virginia. Review the employer’s description below for duties, qualifications and application requirements.
Job description
Commence, headquartered in Virginia Beach, VA, is seeking a Medical Review Manager to lead the Program Integrity workstream for CMS fraud investigations. The role focuses on supervising clinical reviewers, ensuring QA, and coordinating with CMS, CMD, UPICs and law enforcement to protect the Medicare Trust Fund.
The ideal candidate is an RN with 5+ years of clinical and medical review experience, including 3+ years in management, and a strong working knowledge of CMS program integrity rules and
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Worksite address
virginia beach, VA, 23450, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.