[Hiring] PROJECT SPECIALIST (Medical Review Services) @MICHIGAN PEER REVIEW ORGANIZATION

Role Description

The Project Specialist plays a critical role supporting medical review services across multiple active contracts, with a strong focus on processing and coordinating external reviews for insurance denial appeals and the peer review process. This position is responsible for coordinating contract-specific case work, performing data analysis, and ensuring timely, accurate handling of cases in a high-volume, fast-paced environment.

This role requires a tech-savvy, self-driven, and highly motivated professional who thrives on managing complex workflows, multiple priorities, and detailed administrative processes.

Key Responsibilities

• Process and facilitate external and peer reviews in alignment with contract requirements, ensuring accuracy, timeliness, and compliance.
• Support and coordinate activities across multiple concurrent contracts, managing competing priorities and deadlines.
• Track, analyze, and report on case data using internal systems and review service portals.
• Develop and maintain forms, reports, templates, and other business documentation.
• Provide administrative and operational support to team members, providers, and clients.
• Collaborate and facilitate cross-functional projects and initiatives.
• Coordinate meetings, trainings, and team events.
• Ensure compliance with applicable regulations (HIPAA, FISMA, URAC, CMS).
• Perform other duties as assigned.

Qualifications

• Associate’s degree or 5 years relevant experience required; Bachelor’s degree in a healthcare-related field preferred.
• 2+ years of project or administrative support experience required.
• Project management skills required; CAPM preferred.
• Direct experience processing appeals (internal/external) or peer reviews strongly preferred.
• Proven ability to manage high-volume workloads across multiple contracts.
• Strong written and verbal communication skills.
• Highly organized with excellent attention to detail and deadlines.
• Self-driven with the ability to work independently in a fast-paced environment.

Technical Skills

• Proficiency in Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams).
• Experience with project management tools (e.g., Asana).
• Strong technical aptitude and ability to quickly learn multiple systems and portals.
• Experience working with web-based platforms and data systems.
• Ability to analyze data and develop reports/spreadsheets.

Key Competencies

• Ability to manage multiple contracts and complex appeal workflows simultaneously.
• Strong problem-solving and critical-thinking skills.
• High level of accuracy in handling sensitive, regulated information.
• Independent, proactive, and results-driven work style.
• Clear, professional communication across diverse stakeholders.

Benefits

• This position is 100% remote, offering the flexibility to work from anywhere in the United States.
• Prioritization of work/life balance.
• Investment in employees’ growth through professional development and continuing education opportunities.