Medical Review Manager

1.5 - Medical Review Manager (Rev. 508; Issued: 03-07-14, Effective: 04-08-14, Implementation: 04-08-14) MACs: An effective MR program begins with the strategies developed and implemented by senior management staff. The MACs shall name an MR point of contact referred to as the MR Manager who will act as the primary contact between the contractor and CMS concerning the contractor's MR program. The MR Manager will also have primary responsibility for the development, oversight and implementation of the contractor’s MR Strategy, SAR, and quality assurance process. In addition, the MR Manager shall have the primary responsibility for ensuring the timely submission of required reports. SMRC: An effective Medical Review program begins with the senior management staff. The Contractor shall name a Medical Review point of contact referred to as the Medical Review Manager who will act as the primary contact between the Contractor and CMS concerning the SMRC medical review program. The MR Manager will also have primary responsibility for development, oversight and implementation of the Contractor’s quality assurance process. In addition, the MR Manager shall have the primary responsibility for ensuring the timely submission of required reports. The MR Manager shall be a registered nurse. The MR Manager shall work collaboratively with their Project Manager and Contract Medical Director to plan, implement and evaluate all MR projects/tasks directed by CMS.