Nurse Reviewer – Medicaid
Peraton · United States · US
Utilization Review
Remote
physician
Nurse
Demand78
Career growth65
Healthcare fit85
Remote potential85
Salary band
USD 66k – 106k
5-year outlook
Likely stable mid-level government contractor compensation for licensed clinical reviewers, with modest upward movement into senior review, investigations, or Medicaid compliance roles. Exact salary should be verified directly with the employer.
Clinical license
Required
Applicant reach
moderate
Seniority
mid
Employment type
full-time
Date found
2026-10-23
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 who want non-bedside claims, utilization, or fraud-review work with a large government contractor. Clinicians should weigh the citizenship requirement, possible travel, and court-testimony exposure before applying.
Who should apply
Registered Nurses or Physical Therapists with clinical experience and interest in Medicaid claims, medical necessity review, utilization review, compliance, or healthcare fraud investigations. Nurses with prior claims review, coding exposure, or regulatory knowledge may be especially competitive.
CV angle
Frame real clinical experience around medical record review, clinical decision-making, Medicaid/regulatory exposure, claims or utilization review if applicable, investigative research, documentation, and communication with external stakeholders. Emphasize active licensure and any actual experience with medical necessity, coding, compliance, or fraud/waste/abuse review without overstating non-clinical experience.
Skills to highlight
- Medical record review
- Clinical judgment
- Claims payment or medical necessity review
- Medicaid regulations and compliance
- Fraud, waste, and abuse investigation
- Regulatory research
- Report and correspondence writing
- Communication and organization
Role summary
A Medicaid medical reviewer role at Peraton/SGS that uses clinical licensure and judgment to review medical records and claims, support payment decisions, identify potential fraud or abuse, develop cases, and communicate findings to internal and external stakeholders.
We publish our own intelligence summary, never the full job description. Always confirm details with the employer when you apply.