Remote Independent Medical Reviewer/Pulmonary Disease

We are seeking a Medical Review Specialist with experience in pulmonary disease for our Maryland Independent Review Organization (MD IRO-SAE). Join our team to perform Independent Reviews on medical necessity denial disputes for Medicaid beneficiaries.

• Review and analyze cases to determine medical necessity
• Utilize tools like Salesforce, ERIC, and InterQual
• Provide decision write-ups using the IRAC format

This role requires 24 hours of active practice per week, with varying case volumes. If you have a passion for ensuring quality care, apply now!

As a leading strategic partner to governments across the globe, Maximus helps improve the delivery of public services amid complex technology, health, economic, environmental, and social challenges. With a deep understanding of program service delivery, acute insights that achieve operational excellence, and an extensive awareness of the needs of the people being served, our employees advance the critical missions of our partners. Maximus delivers innovative business process management, impactful consulting services, and technology solutions that provide improved outcomes for the public and higher levels of productivity and efficiency of government-sponsored programs. For more information, visit maximus.com.