Part-time Associate Medical Director - Utilization Review

MRIoA • Mountain View, CA

2d • Remote

About The Position

Medical Review Institute of America (MRIoA) is a nationally recognized leader in utilization management and clinical review services, delivering evidence-based solutions for more than 43 years. We are currently seeking a part-time Physician Advisor to join our growing, fully remote team.
POSITION OVERVIEW
In this role, you will apply your clinical expertise to evaluate requests for medical services, interpret benefit language and medical policies, and make sound coverage determinations. You may also engage in peer-to-peer discussions with treating providers. This position emphasizes independent clinical judgment, thorough documentation, and collaboration with a nationwide team of Medical Directors.

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 (no other board-certified specialty is currently needed).
• Possess a minimum of 5 years of direct patient care experience.
• High level of computer proficiency and comfort with multiple software programs
• Ability to be fully dedicated during scheduled work hours (Caregiving or other responsibilities during work hours are not permitted)
• Must reside and work within the United States

Responsibilities

• 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

What This Job Offers

• Job Type: Part-time
• Career Level: Director
• Education Level: No Education Listed
• Number of Employees: 101-250 employees