Part-Time Medical Director

🕒 April 10

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Medical Review Institute of America, LLC

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1983

⚕️ Healthcare Insurance

☁️ SaaS

Healthcare Insurance • SaaS • Data

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

• 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.

🏖️ Benefits

• Flexibility in work hours • Ability to work remotely