Pulmonology Utilization Reviewer – Indiana Licensed

🔥 1 minute ago

🇺🇸 United States – Remote

⏳ Contract/Temporary

🟡 Mid-level

🟠 Senior

Where this job comes from

Posted on Medical Review Institute of America, LLC's careers page, not through a job board

First seen by Remote Rocketship 1 minute ago

Logo of Medical Review Institute of America, LLC

Medical Review Institute of America, LLC

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 • Participate in peer-to-peer conversations during daytime hours • Perform clinical medical reviews as part of MRIoA’s utilization management and independent review services • Protect the confidentiality, privacy, and security of sensitive health information

🎯 Requirements

• Board-Certified physician in Pulmonology • Medical Degree MD or DO • Current, unencumbered medical license in Indiana • Current Board Certification in Pulmonology • 5 years of clinical experience, residency included • Daytime availability for peer-to-peer conversations • Must work remotely from within the United States because patient records cannot leave the US • Adherence 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 • Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding confidentiality, privacy, and security of sensitive health information

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