Family Medicine/Sports Medicine Utilization Reviewer, PA Licensed – 1099 Contractor

🔥 2 hours ago

🔔 Pennsylvania, Utah – Remote

🔔 Pennsylvania – Remote ⛷️ Utah – Remote

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Medical Review Institute of America, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1983

🛡️ Insurance

💼 Consulting

⚖️ Legal

Insurance • Consulting • Legal

Medical Review Institute of America, LLC is a company specializing in clinical and utilization review services. They offer a comprehensive suite of data-driven solutions, including prior authorization optimization, second opinions, and specialty drug reviews, aimed at ensuring the right care is delivered at the right time and in the right place. MRIoA provides services to health plans, pharmacy benefit managers, government entities, and self-insured employers, among others. They leverage technology and a network of professionals to streamline clinical decisions, enhance provider performance, and ensure compliance with regulatory requirements across all 50 states. Their tools and platforms are designed to optimize clinical reviews, reduce costs, and improve patient outcomes through evidence-based care pathways and telehealth solutions.

📋 Description

• Conduct independent Utilization Reviews • Work remotely from anywhere in the US, with patient records remaining in the US per HIPAA regulations • Participate in peer-to-peer conversations during daytime availability • Adhere to HIPAA regulations and company policies and procedures regarding sensitive health information

🎯 Requirements

• Required State Medical License in Pennsylvania • Requires a fellowship in Sports Medicine • Must have a Medical Degree MD or DO • Must have a current Pennsylvania medical license • Current Board Certification in Family Medicine and have a Fellowship in Sports Medicine • Must have 5 years of clinical experience, residency to be included • Daytime availability is required for peer-to-peer conversations • Must adhere to all applicable HIPAA regulations and company policies and procedures regarding confidentiality, privacy, and security of sensitive health information

🏖️ Benefits

• Flexible, fully remote opportunity requiring just 1–2 hours per week—with no minimum commitment • Covered under MRIoA's Errors and Omissions policy • Independent Contractor (1099) opportunity