Part-Time Associate Medical Director

🕒 April 9

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Medical Review Institute of America

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1983

⚕️ Healthcare Insurance

🤝 B2B

💰 Private equity on 2024-08

Healthcare Insurance • B2B

<Medical Review Institute of America> is a healthcare services organization that provides evidence-based utilization management and independent clinical review services to payers, providers, and employers. For over 40 years it has delivered specialty-matched reviews, prior authorization support, specialty drug review, peer-to-peer consultations, and regulatory guidance through a nationwide network of licensed physicians, nurses, and pharmacists, supported by tech-enabled processes and analytics to improve care decisions, control costs, and ensure compliance.

📋 Description

• Perform clinical coverage reviews using member benefits, medical policies, and established clinical guidelines • Interpret benefit language to support accurate and compliant determinations • Document review outcomes in alignment with regulatory, accreditation, and internal standards • Participate in peer-to-peer discussions with treating providers as needed • Collaboration with Medical Directors across multiple specialties and regions

🎯 Requirements

• Hold an active, unencumbered state licensure as a Medical Doctor (MD/DO), any state. • Hold current board certification in either Family Medicine or Internal Medicine. • Possess a minimum of 5 years of direct patient care experience, most recent experience no less than 6 months ago. • High level of computer proficiency and comfort with multiple software programs. • Ability to be fully dedicated during scheduled work hours is required, productivity standards requirements must be met. • Must reside and work within the United States.

🏖️ Benefits

• All necessary computer equipment is provided • Malpractice insurance is not required, as physicians do not provide direct patient care. • Reviewers are covered under MRIoA's Errors and Omissions policy.