
501 - 1000 employees
Founded 1983
🛡️ Insurance
đź’Ľ 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.
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501 - 1000 employees
Founded 1983
🛡️ Insurance
đź’Ľ 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.
• Develop, maintain, and continuously improve enterprise SDLC and ADLC standards, policies, procedures, templates, and governance frameworks • Establish lifecycle governance models for traditional application development, AI-enabled applications, Copilot solutions, and agentic AI or multi-agent solutions • Define and manage delivery stage gates, approval processes, quality checkpoints, and governance reviews • Maintain SDLC and ADLC process documentation, playbooks, standards, and reference materials • Partner with development, architecture, security, QA, Product, and operations teams • Lead the design and implementation of enterprise ADLC standards • Define governance processes for AI use-case intake, prompt engineering, human-in-the-loop controls, agent testing, production deployment, and AI observability • Establish AI quality and evaluation frameworks covering accuracy, grounding, hallucination monitoring, reliability, security, and Responsible AI compliance • Develop controls for AI risk management, model traceability, and regulatory compliance • Conduct process assessments and maturity evaluations across software delivery teams • Identify workflow improvements and drive Agile, Lean, DevOps, and engineering continuous-improvement initiatives • Facilitate process workshops, retrospectives, governance reviews, change management, and organizational transformation • Configure and maintain Jira workflows, issue types, permissions, automations, dashboards, and reporting • Design and maintain Confluence knowledge repositories, process libraries, templates, and governance artifacts • Govern GitLab branching strategies, merge-request standards, release management, and CI/CD controls • Administer SharePoint governance repositories and documentation platforms • Develop SDLC and ADLC performance metrics, dashboards, and executive reporting • Analyze delivery, process, AI adoption, agent performance, and Responsible AI compliance trends • Develop and execute SDLC and ADLC audit programs and conduct compliance reviews • Assess lifecycle-policy, quality-standard, and regulatory adherence • Identify risks and control gaps, develop corrective action plans, and track remediation • Support internal and external audits • Audit vendor performance against SLAs and lead vendor SOW compliance reviews
• 8+ years of experience in SDLC governance, PMO, software engineering, DevOps, or technology delivery leadership • 5+ years of experience developing and managing enterprise software delivery processes and governance frameworks • Hands-on experience administering and configuring Jira, Confluence, GitLab, and SharePoint • Strong understanding of Agile/SAFe, Waterfall, and hybrid delivery methodologies • Knowledge of DevOps and CI/CD practices • Experience defining KPIs, governance metrics, scorecards, and executive dashboards • Experience performing process audits, compliance reviews, and maturity assessments • Strong analytical, communication, facilitation, and stakeholder management skills • Experience supporting AI, Generative AI, Copilot, or Agentic AI initiatives preferred • Experience implementing governance and controls within regulated environments preferred • Experience developing or governing Agentic AI and Generative AI delivery processes • Familiarity with Microsoft Copilot ecosystem, Azure AI Foundry, Azure OpenAI, LLMOps practices, AI governance frameworks, and Responsible AI principles • Experience implementing process automation and workflow orchestration • Healthcare industry experience strongly preferred • Understanding of healthcare regulatory and compliance frameworks including HIPAA and HITRUST • Bachelor's degree in Computer Science, Information Technology, Engineering, Business, or related field required • Preferred certifications include PMP, PMI-ACP, SAFe Agilist, Certified Scrum Master (CSM), ITIL Foundation, Lean Six Sigma Green Belt or Black Belt, Atlassian Certified Professional, GitLab Certified Professional, and Microsoft AI certifications • Ability to sit at a desk and utilize a computer, telephone, and other basic office equipment • Must pass a background screen before beginning employment • Must complete a drug screen after hiring • Must agree to necessary compliance regulations on the first day • Must adhere to applicable HIPAA regulations and company policies regarding confidentiality, privacy, and security of sensitive health information
• A competitive compensation package • Healthcare, vision, and dental insurance • Generous 401k match • Paid vacation, personal time, and holidays • Growth and training opportunities • Award-winning remote working environment
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