Associate Director, Medical Review Lead, MSRM - Remote Agios PharmaceuticalsAssociate Director, Medical Review Lead, MSRM - RemoteSan Diego, CARemote$185,369–$308,948 / yearThe current base salary range for this position is expected to be between $185,369 and $308,948 annualized; final salary will be determined based on various factors including, but not limited to, years of relevant experience, job knowledge, skills and proficiency, degree/education, and internal comparators. This role provides oversight of medical review for Individual Case Safety Reports (ICSRs) across investigational and marketed products, ensuring medical accuracy, regulatory compliance, and high-quality safety data to support pharmacovigilance and risk management activities.
Quality Associate, Batch Record Review and Product Disposition Travere Therapeutics IncQuality Associate, Batch Record Review and Product DispositionSan Diego, CARemote$85,000–$105,000 / yearPosition Summary: The Quality Associate supports Quality Operations through the Quality oversight of Manufacturing, Packaging, and Labeling Operations Batch Record Review, Product Disposition, Clinical and Commercial Supplier Management Oversight, quality records management, and GxP Metrics reporting. Perform QA Batch Review and Approval of intermediates, drug substance, and final products ensuring all required quality records are complete and compliant prior to product disposition to meet clinical and commercial production timelines.
Medical Assistant County of San BernardinoMedical AssistantSan Bernardino, CA$41,537.60–$57,054.40 / yearThis position will utilize an Electronic Health Record (EHR) system to document collected data, perform patient intake and obtain information relating to examinations and tests; update records and actively conduct outreach to patients; provide education and information to facilitate patient compliance with appointments, tests, treatment plans and goals to support patients with self-management of disease and behavior modification; care coordination referral management and tracking; monitor established treatment plan, assist with medication management, tests and examinations; advise healthcare professionals of status and participate in the adjustment of patient-centered self-management goals as needed and will utilize chronic disease registry reports to identify disease trends and desired outcomes while understanding the Chronic Care Model. DBH is a unique County Department comprised of eight (8) direct service areas: Community Outpatient and Transitional Age Youth Services; Youth Collaborative and Justice Involved Services; Substance Use Disorder and Recovery Services; 24 Hour and Specialty Services; Adult Justice Involved and Diversion Services; Medical Services; Community Engagement and Equity Services; Office of Patients Rights and five (5) indirect service areas: Administrative and Fiscal Services; Public Relations and Outreach Services; Program Support Services; Disaster and Safety Unit; and the Office of Compliance.
New(RN) Appeals Medical Review Nurse - REMOTE Molina Healthcare Inc(RN) Appeals Medical Review Nurse - REMOTECARemoteREQUIRED QUALIFICATIONS: At least 2 years clinical nursing experience, including at least 1 year of utilization review (prospective, retrospective and concurrent clinical review), medical claims review, long-term services and supports (LTSS), claims auditing, medical necessity review and/or coding experience, or equivalent combination of relevant education and experience. Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level of care utilizing MCG/InterQual, state/federal guidelines, billing and coding regulations, and Molina policies; validates the medical record and claim submitted support correct coding to ensure appropriate reimbursement to providers.
Senior Medical Records Collector - Hybrid (Must reside in San Diego, CA) Molina Healthcare IncSenior Medical Records Collector - Hybrid (Must reside in San Diego, CA)San Diego, CAResponsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database.
System Manager - HIM Medical Records University Health Services IncSystem Manager - HIM Medical RecordsTEMECULA, CADuties include but not limited to: • Participates in Emergency Preparedness Drills • Demonstrates through practice drills and upon request understanding of his/her role in the event of an emergency or disaster • Facilitates departmental and hospital educational activities and inservices in conjunction with the Education Department • Responsible for development, review and revision of departmental written policies and procedures • Ensures that the department has equipment, supplies necessary to provide consistent quality and service delivery • Reports any unsafe situations or safety hazards immediately • Labels and removes any malfunctioning equipment from service and notifies Office Manager and/or Plant Ops. Southwest Healthcare is comprised of five acute care hospitals and several non-hospital access points, including: • Corona Regional Medical Center • Palmdale Regional Medical Center • Southwest Healthcare Rancho Springs Hospital • Southwest Healthcare Inland Valley Hospital and Temecula Valley Hospital • Temecula Valley Day Surgery • A+ Urgent Care Centers • Apex Heart Specialists • Riverside Medical Clinics.
Medical Records Director Sun Mar Health CareMedical Records DirectorLos Angeles, CaliforniaDevelop and maintain a good working rapport with inter-department personnel, as well as other departments within the facility to assure that medical records can be properly maintained and problem areas can be identified and corrected. We are a skilled nursing facility looking for dynamic associates to join our clinical team and provide our guests with a care experience that will change their lives!
Medical Records Clerk (Marengo) Clinica Monsenor Oscar A RomeroMedical Records Clerk (Marengo)Los Angeles, CAUsage of OnBase scanning module in order to scan batches of various medical records documents to upload documents through batch to index interphase into OnBase Indexing processing Usage of OnBase Production module for processing with incorporated data fields with attention to detail in the description to index, commit, and batch various types of patient medical records documents and/or reports through OnBase Production mode module to interphase in EPIC EMR files for end-user accessibility of records for continuity of care and Through automatization workflows, maintains EPIC ROI electronic Module for various types of Release of Information requests and Identifying the requestor as Third Party, Patient, relation, and/or Provider request by verifying demographics. Typing a minimum 35 WPM and proficient computer skills; including but not limited to Microsoft products and use of outlook Ability to communicate effectively, verbal and written; work without close supervision, detail oriented and well Customer service skills: communication, empathy, patience, and technical knowledge Work in team-oriented environment, and work well under Previous experience in a community clinic setting Bi-lingual English and Ability to handle multiple tasks and work in a busy Ability to work evenings and weekends Ability to work at multiple clinic Knowledge of office equipment use such as Computer, Scanner, Fax, Email, eFax, Telephone, electronic communication platforms and/or upload.
Medical Records Assistant Pine Creek Care CenterMedical Records AssistantRoseville, CAFull timeFile important documents such as nurses' notes, assessments, progress notes, lab reports, x-rays, and physician reports into resident charts. As our Medical Records Coordinator, you'll play a vital role in ensuring accurate, secure, and well-organized health information that supports quality care for our residents.
Medical Records Specialist Full Time Temporary Pulmonary Medicine AssociatesMedical Records Specialist Full Time TemporarySacramento, CA$24–$28.30 / hourWith specialties that include critical care, infectious disease, palliative care, pulmonology, pediatric pulmonology, sleep medicine, and travel medicine, we are a busy practice with over 80 providers and 2 outpatient clinic locations. Pulmonary Medicine Associates (PMA) has been treating patients in the greater Sacramento area for over 50 years and is a unique and exciting place to work.
Prior Authorization, Referral, and Medical Records Coordinator Astrana Health IncPrior Authorization, Referral, and Medical Records CoordinatorAlhambra, CAMinimum of __1___ year experience in prior authorization, referrals, clinical operations, or related functions Strong verbal and written communication skills; must be able to communicate in a professional and courteous manner. You"re great for this role if: Knowledge of managed care and medical insurance plans Knowledge of Elation EHR or similar system Experience with medications, injections, biologics, and specialty treatment authorizations.
Medical Records Assistant Stoney Point Healthcare CenterMedical Records AssistantChatsworth, CAFull timeEnsure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen-saver activates within established facility policy guidelines. General PurposeThe primary purpose of your job position is to maintain resident medical records and health information systems in accordance with current federal and state guidelines as well as in accordance with our facility's established privacy policies and procedures.
Health Information Manager (Medical Records) - SNF Sunnyside Nursing and Post-Acute CareHealth Information Manager (Medical Records) - SNFTorrance, CA$85,000–$95,000DOCUMENTATION AND RECORD COMPLETION: Works with clinical staff, physicians, consultants, nurses, therapists, etc., to ensure documentation is in compliance with hospital, accrediting, and licensing guidelines and provides ongoing education to staff. When applicable, serves as a key player in providing oversight in the appropriate assignment of Impairment Groups under the Preferred Payment System (PPS) for Rehabilitation and UDS data submission, as applies to rehab locations.
Medical Record Collector Emergency UniversityMedical Record CollectorSan Jose, CaliforniaThe Medical Record Collector will be responsible for gathering and maintaining accurate medical records for our online training programs. We are seeking a highly organized and detail-oriented Medical Record Collector to join our team.
Certified Medical Records Coder-Outpatient (Swing/Weekend) County of Riverside, CaliforniaCertified Medical Records Coder-Outpatient (Swing/Weekend)Riverside, CA$64,311.76–$95,813.52 / yearLicense/Certificate: Possession of current valid certification as a Certified Coding Specialist (CCS); or Certified Coding Specialist-Physician based (CCS-P); or Registered Health Information Administrator (RHIA); or a Registered Health Information Technician (RHIT) issued by American Health Information Management Association; or Certified Professional Coder (CPC); or Certified Professional Coder-Hospital (CPC-H) issued by the American Academy of Professional Coders. I understand that I must upload a copy of one or more of the following certificates, before submitting my application - Registered Health Information Administrator (RHIA) or Certified Professional Coder-Hospital (CPC-H) issued by the American Academy of Professional Coders or Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT) issued by the American Health Information Management Association or Certified Coding Associate (CCA), and/or Certified Coding Specialist (CCS).
Medical Records Data Entry Specialist Guardian Pharmacy LLCMedical Records Data Entry SpecialistSan Diego, CA$23–$27 / hourBecause healthcare is an ever-changing industry, we encourage innovative thinking, intellectual curiosity, and diverse viewpoints to ensure we stay competitive in today's dynamic business environment. Who We Are and What We're About: Our core focus is delivering customized medication management solutions to support healthcare organizations serving seniors and individuals with complex care needs.
Medical Records Quality Assurance Coordinator Crestwood Behavioral Health IncMedical Records Quality Assurance CoordinatorCA$25–$30 / hourFor more than 50+ years Crestwood has been committed to creating innovative recovery programs and developing compassionate communities that support each client in their journey. The facility provides a versatile array of classes for clients to participate in during their recovery program and encourages active participation in treatment planning from the moment of admission.
Medical Records Compliance Coordinator (Quality Assurance Coordinator) Crestwood Behavioral HealthMedical Records Compliance Coordinator (Quality Assurance Coordinator)Angwin, CA$25–$28.98 / hourFor more than 50+ years Crestwood has been committed to creating innovative recovery programs and developing compassionate communities that support each client in their journey. The facility provides a versatile array of classes for clients to participate in during their recovery program and encourages active participation in treatment planning from the moment of admission.
Medical Records Auditor Crestwood Behavioral HealthMedical Records AuditorSan Jose, CA$25.75–$28.98 / hourWe provide medication management, WRAP, DBT support, welcoming rituals, behavioral interventions, psychotherapy, psychosocial education and a thorough transition plan to enable a successful return to the community. The San Jose PHF provides a spacious environment, with two living rooms, a welcoming room, visiting space, serenity room, dining room and a beautiful courtyard.
NewMedical Records Coordinator, Skilled Nursing Community Health SystemMedical Records Coordinator, Skilled NursingFresno, CaliforniaQualifications: Education • High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required • Successful completion of a college level course work or medical terminology course preferred Experience • 2 years of medical record experience required • Microsoft Office (e.g., Outlook and Excel) and basic data entry skills required • Experience with PointClickCare or EHR systems (preferably in a Skilled Nursing facility/setting) preferred Disclaimers: • Pay ranges listed are an estimate and subject to change. Duties include reviewing resident electronic health record (EHR) documentation and provider visit documentation; monitoring of notes and reporting findings to the clinical and interdisciplinary team (IDT); EHR filing/scanning; and setting up and closing resident charts.
NewMedical Records Specialist Actalent IncMedical Records SpecialistLos Angeles, CA$23–$25 / hourWe are proud to be an Engineering News-Record (ENR) Top 500 Design Firm for our engineering design services and a ClearlyRated Best of Staffing winner for both client and talent service. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.
Medical Records Director PACS Group IncMedical Records DirectorCAThis role ensures timely documentation, supports clinical and administrative staff, and maintains confidentiality and integrity of all medical information within the skilled nursing facility. The Medical Records Director oversees the management, security, and accuracy of resident health records in compliance with federal, state, and facility regulations.
Medical Record Director- Part time PACS Group IncMedical Record Director- Part timeCAThis role ensures timely documentation, supports clinical and administrative staff, and maintains confidentiality and integrity of all medical information within the skilled nursing facility. The Medical Records Director oversees the management, security, and accuracy of resident health records in compliance with federal, state, and facility regulations.
Medical Records Dir PACS Group IncMedical Records DirSage Creek Post Acute, CAThis role ensures timely documentation, supports clinical and administrative staff, and maintains confidentiality and integrity of all medical information within the skilled nursing facility. The Medical Records Director oversees the management, security, and accuracy of resident health records in compliance with federal, state, and facility regulations.
Medical Records Director-S PACS Group IncMedical Records Director-SCAThis role ensures timely documentation, supports clinical and administrative staff, and maintains confidentiality and integrity of all medical information within the skilled nursing facility. The Medical Records Director oversees the management, security, and accuracy of resident health records in compliance with federal, state, and facility regulations.
Medical Records Assistant-Part time Beverly Hills Rehabilitation CentreMedical Records Assistant-Part timeLos Angeles, CAPart timeEnsure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen saver activates within established facility policy guidelines. Assist in developing procedures to ensure resident records are properly completed, assembled, coded, signed, indexed, etc., before filing.
NewMedical Records Assistant PACS Group IncMedical Records AssistantCA$19–$20 / hourIf you enjoy staying organized, working collaboratively, and helping ensure residents receive exceptional care through accurate health information management, we'd love to hear from you. Occasionally, this position may require flexibility to work beyond regularly scheduled hours, including weekends, holidays, or during emergency situations when additional support is needed.
Medical Records Clerk L.A. Injury AttorneysMedical Records ClerkBurbank, CaliforniaInjury Attorneys is one of the top rated personal injury law firms in California and belongs to the Million Dollar Advocates Forum and the Multi- Million Dollar Advocates forum which is exclusive to those law firms that have excelled in their profession and secured multi-million dollar settlements and verdicts for their clients. At La Injury Attorneys, we have the necessary investigators, paralegals, and experienced attorneys to obtain the pertinent information to secure the highest possible settlements and/or verdicts for our clients.
Medical Records Specialist Pacific GroveMedical Records SpecialistRiverside, California$25–$29 / hourFull timeOverview: Pacific Grove Hospital in Riverside, CA., is a leader in behavioral healthcare, providing superior healthcare treatment to the people, communities, and military installations we serve. We are seeking a Medical Record Specialist to assist with Maintaining medical record integrity through filing, assembling, analysis and retrieving confidential patient records.
Regional Medical Records PACSRegional Medical RecordsCaliforniaEssential demands include manual dexterity for computer and office equipment use, clear verbal and written communication, and the ability to lift up to 25 pounds occasionally for handling files and office supplies. The Regional Medical Records Consultant will work closely with Medical Records Managers and various leadership roles throughout facilities within the region and staff to maintain the security and confidentiality of patient information.
NewMedical Records Specialist HCA HealthcareMedical Records SpecialistThousand Oaks, CA$19.70–$27.58 / hourIn recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts.
Medical Records Analyst Atria Health and Research InstituteMedical Records AnalystBeverly Hills, CA$70,000–$85,000After successfully opening our flagship Institute in New York in 2022 and expanding to South Florida in 2024, we are now bringing the Atria experience to the West Coast with the launch of our Los Angeles Institute in late spring 2026. Collaborate with Atria Teams to answer inquiries in response to requests related to forms, medical records, program, and storage systems utilized in securing access to medical records.
ROI Medical Records Specialist MRO CorporationROI Medical Records SpecialistPalmdale, California$16–$22 / hourFull timeResponsibilities: Determines records to be released by reviewing requestor information in accordance with HIPAA guidelines and obtaining pertinent patient data from various sources, including electronic, off-site, or physical records that match patient request. Overview: The ROI Specialist is responsible for providing support at a specified client site for the Release of Information (ROI) requests for patient medical record requests*.
Medical Records Director - Antelope Valley Care Center Antelope Valley Care CenterMedical Records Director - Antelope Valley Care CenterLancaster, CAFull timeMaintain and Organize Medical Records: Collect, assemble, and file resident charts including nurses' notes, lab reports, x-rays, and progress notes to ensure all documentation is complete, accurate, and filed per facility policy. Administrative Accountability: Assume full responsibility for assigned duties, maintain census data and reports, attend required trainings (OSHA, HIPAA, etc.), and perform other tasks as assigned.
Medical Records Specialist - El Segundo Thompson Law Injury LawyersMedical Records Specialist - El SegundoEl Segundo, CAFull timeThompson Law’s vision is to be the law firm of choice for every person injured or killed due to preventable tragedy while providing our clients world-class service and record-setting results. If you're ready to contribute your talents as part of one of the fastest-growing personal injury firms while enhancing your skills within a dynamic environment—apply today!
Medical Records Clerk STARS BEHAVIORAL HEALTH GROUP, INC.Medical Records ClerkFresno, CAManages the completion of documents and maintains the system to ensure completion of required documents. We're proud to have been certified as a Great Place to Work for 8 years by our own employees.
Medical Records Clerk - Hospitalist, Santa Monica University of CaliforniaMedical Records Clerk - Hospitalist, Santa MonicaSanta Monica, CA$23.58–$33.05 / hourStarting June 1, 2026, SB525 sets a new $25/hour minimum wage for nonexempt healthcare workers and raises the exempt employee salary threshold to $1,500/week (equivalent to $6,500/month or $78,000/year). As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.
Physical Medicine & Rehabilitation Telecommute Medical Review Stream Physician Concentra Inc.Physical Medicine & Rehabilitation Telecommute Medical Review Stream PhysicianLos Angeles, CACurrent, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE: Post-graduate experience in direct patient care JOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills -Demonstrated ability to perform review services.
Spine Surgeon Telecommute Medical Review Stream Physician Concentra Inc.Spine Surgeon Telecommute Medical Review Stream PhysicianSouth San Francisco, CACurrent, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer. -Must be in active medical practice to perform appeals JOB-RELATED EXPERIENCE: Post-graduate experience in direct patient care JOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills -Demonstrated ability to perform review services.
Orthopedic Surgeon Telecommute Medical Review Stream Physician Concentra Inc.Orthopedic Surgeon Telecommute Medical Review Stream PhysicianMadera, CA$30–$90 / hourMust be in active medical practice to perform appeals JOB-RELATED EXPERIENCE:Post-graduate experience in direct patient careJOB-RELATED SKILLS/COMPETENCIES: -Demonstrated computer skills, telephonic skills-Demonstrated ability to perform review services.-Ability to work with various professionals including members of regulatory agencies, carriers, employers, nurses and health care professionals. -Current, unrestricted clinical license(s) (or if the license is restricted, the organization has a process to ensure job functions do not violate the restrictions imposed by the State Board); -Board certification by American Board of Medical specialties or American Board of Osteopathic Specialties is required for MD or DO reviewer.
Medical Records Assistant La Paloma Healthcare CenterMedical Records AssistantOceanside, CAFull timeEnsure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen saver activates within established facility policy guidelines. Assist in developing procedures to ensure resident records are properly completed, assembled, coded, signed, indexed, etc., before filing.
Medical Records Assistant FT - CCHC Cottonwood Canyon Healthcare CenterMedical Records Assistant FT - CCHCEl Cajon, CAFull timeEnsure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen-saver activates within established facility policy guidelines. General PurposeThe primary purpose of your job position is to maintain resident medical records and health information systems in accordance with current federal and state guidelines as well as in accordance with our facility's established privacy policies and procedures.
NewMedical Records Assistant-H PACS Group IncMedical Records Assistant-HCAEnsure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen-saver activates within established facility policy guidelines. Assist in developing procedures to ensure resident records are properly completed, assembled, coded, signed, indexed, etc., before filing.
Medical Records Assistant - Antelope Valley Care Center PACS Group IncMedical Records Assistant - Antelope Valley Care CenterCAEnsure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen-saver activates within established facility policy guidelines. Assist in developing procedures to ensure resident records are properly completed, assembled, coded, signed, indexed, etc., before filing.
Medical Records Assistant - Antelope Valley Care Center Antelope Valley Care CenterMedical Records Assistant - Antelope Valley Care CenterLancaster, CAFull timeEnsure that departmental computer workstations left unattended are properly logged off or the password protected automatic screen-saver activates within established facility policy guidelines. General PurposeThe primary purpose of your job position is to maintain resident medical records and health information systems in accordance with current federal and state guidelines as well as in accordance with our facility's established privacy policies and procedures.
Supervisor, Medical Records, Release of Information MRO CorporationSupervisor, Medical Records, Release of InformationSan Francisco, California$51,000–$69,000 / yearFull timeThe Area Supervisor will act as the liaison between MRO and Client Management staff to ensure that all ROI activities are compliant with established client policies, federal and state regulations and are completed in a timely manner. Promotes a positive self-image of MRO with emphasis on customer service by treating patients, co-workers, and medical center personnel with courtesy and respect.
Temporary Medical Records Director The Pines at Placerville Healthcare CenterTemporary Medical Records DirectorPlacerville, CAFull timeThis role partners closely with clinical and administrative teams to support timely documentation, survey readiness, and the overall integrity of health information within our skilled nursing facility. Position OverviewThe Medical Records Director oversees the management, accuracy, and security of resident medical records, ensuring compliance with HIPAA, state, federal, and facility regulations.
Medical Records Director The Pines at Placerville Healthcare CenterMedical Records DirectorPlacerville, CAFull timeThis role ensures timely documentation, supports clinical and administrative staff, and maintains confidentiality and integrity of all medical information within the skilled nursing facility. General PurposeThe Medical Records Director oversees the management, security, and accuracy of resident health records in compliance with federal, state, and facility regulations.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)CA$50,460–$72,644 / yearRequired as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only." Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Medical Review Officer (MRO) - Bid MaximusMedical Review Officer (MRO) - BidLos Angeles, CAFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. - After completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service.