Medical Review Analyst - Medicare
Peraton · United States · US
Utilization Review
Remote
physician
Nurse
Demand72
Career growth60
Healthcare fit84
Remote potential75
Salary band
USD 66k – 106k
5-year outlook
Government-contractor medical review roles tend to offer stable, mid-level compensation with modest annual increases tied to contract renewals and federal budgets. Advancement typically comes through senior reviewer, audit, or program integrity leadership tracks rather than rapid salary jumps.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-07
Intelligence details
Flexible work details
- Side income
- Classified as side-income friendly
- Engagement type
- Contract
- Hours
- Variable hours
- Eligible countries
- United States
- License jurisdiction
- US
- Profession fit
- physician, Nurse
- Rate period
- Annual
Why this was classified this way
- contract
Listing via Himalayas.
Eligibility, licensing, and location restrictions can change. Always confirm details on the source posting before applying.
Why this is worth applying to
Worth considering for licensed nurses or physical therapists seeking a stable, telework-friendly exit from bedside care into Medicare program integrity work. The clinical license requirement narrows competition, but the 3-7 year experience bar and citizenship requirement mean it is not an entry-level pivot.
Who should apply
Registered nurses and physical therapists with 3-7+ years of clinical experience, especially those with prior claims review, utilization review, case management, or medical necessity experience. Clinicians interested in fraud, waste, and abuse investigation, regulatory compliance, or government contracting are strong fits.
CV angle
Reframe bedside and clinical experience around chart review, clinical documentation accuracy, medical necessity judgment, and application of payer/regulatory criteria. Emphasize volume of records reviewed, interdisciplinary coordination, quality/compliance exposure, and any experience interpreting Medicare or insurance coverage rules. Highlight investigative curiosity, report writing, and independent case handling without overstating non-clinical experience.
Skills to highlight
- Medical record and chart review
- Medical necessity determination
- Medicare coverage and payment rules
- Claims analysis and payment decision-making
- Fraud, waste, and abuse detection
- Clinical documentation and coding knowledge (CPC)
- Investigative research and case development
- Written reporting and correspondence
Role summary
A Medicare-focused Medical Review Analyst at Peraton's SafeGuard Services conducts medical record reviews, applies clinical judgment to claim payment and medical necessity decisions, and supports fraud, waste, and abuse investigations. The role involves data analysis, regulatory research, case development, report writing, and possible court testimony, with telework available from the contiguous U.S.
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