Medical Director (Physician Advisor)

Medical Review Institute of America • Full-time • from $240k / year • 6h ago

Description

Who We Are - Motivated by Purpose. Powered by Clinical Expertise.

Founded in 1983, we’re a clinically driven, tech-enabled utilization management company offering expert clinical reviews, regulatory guidance, and actionable insights to healthcare organizations.

Excellence starts with our people.

WE OFFER

A competitive compensation package.
Benefits include healthcare, vision and dental insurance, a generous 401k match, paid vacation, personal time, and holidays.
Growth and training opportunities.
A team atmosphere with fun events and prizes scheduled throughout the year.

Position Summary

Our Medical Director leverages their medical experience and judgment to determine whether requested services, levels of care, and/or sites of service should be authorized. This role operates within a framework of criteria from the patient’s healthcare plan, regulatory compliance, and utilizing diverse resources such as national clinical guidelines, CMS policies, clinical reference materials, internal teaching conferences, and other references.

Key Responsibilities

Medical Decision Making: Leverage in-depth inpatient clinical expertise, including familiarity with MCG/InterQual guidelines and health plan policies, along with acute care, co-morbidities, and disease management experience, to review medical records and deliver evidence-based determinations on service requests.
Communication: Conduct peer-to-peer phone calls with external providers to obtain additional clinical information and discuss case determinations.
Collaboration: Follow established procedures to support internal workflows and foster effective working relationships across teams and stakeholders.
Compliance and Support: Ensure all decisions and processes adhere to national guidelines, CMS regulations, URAC standards, clinical best practices, and contractual requirements.

Work Schedule

40 hours per week
Five 8-hour shifts or four 10-hour shifts (available after training)
Shifts scheduled between 6:00 AM – 7:00 PM MST
Includes 2–3 weekend shifts per month
Schedules are released 60 days in advance
Schedules are fixed; dedication during scheduled hours is required

Compensation & Additional Information

The permanent starting salary for this position is $240,000 annually and includes a full benefits package.

Requirements

Skills and Experience

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 (no other board-certified specialty is currently needed).
Possess a minimum of 5 years of direct patient care experience, with the most recent experience no less than 6 months ago (recent clinical care is essential).
Be willing to obtain up to 20 additional state licenses (MRIoA covers the cost of licenses and CME requirements to maintain them).
Have a clean background, without prior licensure issues, pending malpractice cases or legal issues.
Possess excellent verbal and written communication skills.
Excellent interpretation skills, divergent/creative thinking skills.

Equipment Requirements

All necessary computer equipment is provided.
A hard-wired Ethernet connection is preferred, but a reliable Wi-Fi connection is also acceptable

Additionally:

Must be fully dedicated to the job during your scheduled hours. This is a busy position and does not allow for caregiving responsibilities during scheduled work hours.
Malpractice insurance is not required, as physicians do not provide direct patient care. Reviewers are covered under MRIoA's Errors and Omissions policy.

Work Environment:

Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home).

Diversity Statement:

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Drug-Free Workplace:

This company is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen, as well as agreeing to all necessary Compliance Regulations on their first day of employment. Employees are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information.

California Consumer Privacy Act (CCPA) Information (California Residents Only):

Sensitive Personal Info: MRIoA may collect sensitive personal info such as real name, nickname or alias, postal address, telephone number, email address, Social Security number, signature, online identifier, Internet Protocol address, driver’s license number, or state identification card number, and passport number.
Data Access and Correction: Applicants can access their data and request corrections. For questions and/or requests to edit, delete, or correct data, please email the Medical Review Institute at HR@mrioa.com.