Physician Utilization Reviewer (Medical Director)

Description

WHO WE ARE

Founded in 1983, Medical Review Institute of America (MRIoA) is the market leader for technology-enabled utilization management and clinical medical review solutions. We have an outstanding reputation for excellence and achieve continual improvement. At MRIoA we believe our employees are the key to our success. Here you are more than just a cog in the machine – you are a valued member of our family.

GETTING DOWN TO BRASS TACKS

Our Physician Reviewer (Medical Directors) play a critical role at MRIoA ensuring accurate and timely clinical determinations are produced on behalf of our clients (Utilization Reviews). Utilizing your clinical knowledge, in conjunction with healthcare plan criteria and nationally recognized medical guidelines, you would evaluate and adjudicate clinical services requests. You would also engage in peer-to-peer outreach with treating providers, as appropriate. 

It is important to note, that due to the short turn-around-time frames of the cases completed by our Medical Directors, (typically within a few hours), a set work schedule of 40 hours per week is required. The schedule will vary, working 5, 8-hour days (or 4, 10-hours a days) per week, between the hours of 6am to 7pm MTN TIME ZONE. This includes a weekend rotation – 2-3 days per month.

Requirements

YOU ARE

• A physician, board certified in either Internal Medicine or Family Medicine, with at least 5 years of direct patient care experience (post residency), and less than 1-year laps in current direct patient care responsibilities.
• Willing and able to be flexible with changes as needed, including working occasional additional hours as needed.
• Able to easily navigate through several computer programs/portals throughout the workday.

REQUIREMENTS

• MD or DO degree, required.
• Current board certification in Family medicine or Internal Medicine, by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) - required.
• Current, unencumbered medical license/s as required for clinical practice in any state of the United States.
• Ability and desire to obtain additional state licenses as required for the position.
• Ability to pass credentialing by the company’s credentialing committee.

BENEFITS

Our robust benefits package includes Medical, Dental and Vision insurance, with low premium costs for employees. A generous 401(k) company match, 31 days of PTO per year, and much more.

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

This company is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen, as well as agreeing to all necessary Compliance Regulations on their first day of employment. 

For California Residents -  California Consumer Privacy Act (CCPA) Information:

Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver’s license number, or state identification card number, and passport number.

Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.