About this role
At Broadway Ventures, we transform challenges into opportunities with expert program management, cutting-edge technology, and innovative consulting solutions. As an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB), we empower government and private sector clients by delivering tailored solutions that drive operational success, sustainability, and growth. Built on integrity, collaboration, and excellence, we’re more than a service provider—we’re your trusted partner in innovation.
RN Senior Medical Reviewer
Position Summary
The RN Senior Medical Reviewer provides advanced medical review expertise and supports oversight of the medical review process, focusing on complex services and quality assurance.
Education
Bachelor of Science in Nursing (BSN)
Licensure / Certifications
Current, active, unencumbered Registered Nurse license in the United States
Certified Coder credentials required
Experience
Minimum of three (3) years of medical record review experience
At least three (3) years of current and/or relevant clinical experience
Two (2) years of quality assurance experience required
Additional Qualifications
Extensive knowledge of the Medicare program
Working knowledge of CMS FFS RAC Program requirements and activities
Key Responsibilities
Assist Medical Review Management with monitoring the medical review process
Conduct medical record reviews for complex services
Evaluate compliance with Medicare coverage, coding, and billing rules
Contribute to medical review and proposal deliverables
Participate in quality assurance activities to ensure consistency and accuracy
What to Expect Next:
After submitting your application, our recruiting team will review your qualifications. This may include a brief telephone interview or email communication to verify resume details and discuss compensation expectations. Interviews will be conducted with the most qualified candidates. Broadway Ventures conducts background checks and drug testing prior to the start of employment. Some positions may also require fingerprinting.
Broadway Ventures is an equal opportunity employer and a VEVRAA federal contractor. We do not discriminate against applicants or employees on the basis of race, color, religion, sex, national origin, age, disability, protected veteran status, or any other status protected by applicable law.
Reasonable accommodations are available for applicants with disabilities. Broadway Ventures utilizes the OFCCP-approved Voluntary Self-Identification of Disability Form (CC-305).
Other facts
About Broadway Ventures
We deliver expert program management, cutting-edge IT, cybersecurity, and consulting solutions for government and commercial clients. Our mission is to drive efficiency and sustainable value, empowering underserved communities and ensuring a lasting impact across sectors such as defense, healthcare, and environmental sustainability. We are an 8(a) certified, HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) dedicated to excellence and innovation.
What you'll do
- The RN Senior Medical Reviewer assists in monitoring the medical review process and conducts reviews for complex services. They evaluate compliance with Medicare rules and participate in quality assurance activities.
Ready to join Broadway Ventures?
Take the next step in your career journey