Senior Medical Review Officer

HireRight•Tulsa, OK

About The Position

The Sr. Medical Review Officer (MRO) serves as the organization’s senior medical authority for drug testing and occupational health review, ensuring all medical determinations are accurate , compliant, defensible, and consistent with federal, state, and client-specific requirements. In addition to medical review responsibilities, the Sr. Medical Review Officer (MRO) serves as an industry subject matter expert, remaining current on emerging drug and alcohol trends, evolving testing methodologies, and regulatory guidance. The MRO may support client and industry education through activities such as webinars, presentations, training sessions, and written thought leadership related to drug testing, substance use trends, and occupational health best practices. The Sr. Medical Review Officer (MRO) must be a licensed physician (MD or DO) and certified by the Medical Review Officer Certification Council and/or American Association of Medical Review Officers (MROCC and/or AAMRO ) with expertise in controlled substance use disorders and a thorough understanding of alternative medical explanations for laboratory-confirmed drug test results. This includes knowledge of issues related to adulterated or substituted specimens, as well as potential medical causes of invalid test results. The Sr. Medical Review Officer (MRO) is responsible for safeguarding the accuracy, integrity, and fairness of the drug testing process. Core duties include reviewing and interpreting non-negative test results and determining , through appropriate medical evaluation, whether legitimate medical explanations may account for such findings. A non-negative result alone does not establish illegal drug use by an employee or applicant. To ensure independence and objectivity, an MRO must not be employed by the testing laboratory unless a clear and documented separation of laboratory and medical review functions is maintained .

Requirements

Licensed M.D. or D.O. by an applicable government authority and must be certified by the Medical Review Officer Certification Council and/or American Association of Medical Review Officers (MROCC and/or AAMRO )
Minimum 7 years of experience serving as a Medical Review Officer in drug and alcohol testing and occupational health environments.
Demonstrated experience performing independent medical review of non-negative drug test results, including donor interviews and prescription verification.
Extensive experience with DOT and non-DOT testing programs
Experience overseeing or supporting high-volume medical review operations, with an emphasis on accuracy, consistency, and turnaround time.
Proven experience participating in or supporting audits, regulatory inquiries, client escalations, or legal reviews related to drug testing results.
Demonstrated ability to apply sound medical judgment in complex, ambiguous, or precedent-setting cases.
In-depth knowledge of DOT, and applicable state and local drug testing regulations.
Comprehensive understanding of DOT and non-DOT drug and alcohol testing programs.
Knowledge of chain-of-custody requirements, confidentiality standards, and data integrity controls.
Familiarity with regulatory audit processes and compliance documentation requirements.
Demonstrates people leadership skills.
Expert knowledge of controlled substances, substance use disorders, and pharmacology relevant to workplace testing.
Understanding of drug metabolism, detection windows, cross-reactivity, and cutoff concentrations.
Knowledge of legitimate medical explanations for non-negative and invalid test results.
Understanding of specimen validity testing, including adulterated, substituted, diluted, and invalid specimens.
Knowledge of emerging drug classes and misuse trends (e.g., synthetic opioids).
Knowledge of laboratory testing processes and methodologies, including immunoassay screening and confirmatory testing (e.g., GC/MS).
Familiarity with alternative testing matrices such as oral fluid and hair testing.
Understanding of evolving testing technologies and regulatory guidance.

Responsibilities

Provide clinical leadership and mentorship to MROs and medical review staff.
Ensure strict adherence to chain-of-custody, confidentiality, and data integrity standards.
Provide executive oversight of Medical Review Officer (MRO) activities related to drug and alcohol testing.
Serve as the ultimate medical decision-maker for complex, escalated, or precedent-setting drug test result determinations.
Oversee interpretation and verification of laboratory test results, including donor interviews and prescription verification standards.
Establish, maintain , and update medical review policies, procedures, and clinical decision frameworks.
Lead quality assurance initiatives to ensure consistent, fair, and timely MRO determinations.
Partner with Compliance, Legal, and Operations to support audits, client inquiries, and regulatory reviews.
Act as a medical subject matter expert in disputes, appeals, and litigation support, as needed.
Monitor emerging trends in substance use, testing methodologies, and regulatory guidance to proactively adjust practices.
Comfort working with technology-enabled review platforms and data analytics.
Shall comply with all MRO requirements as specified in the DOT Procedures for Transportation Workplace Drug and Alcohol Testing Programs, 49 CFR Part 40.