Medical Review Institute of America

Utilization Review Work for Physicians - Remote, Full Time

REMOTEPosted 30+ days ago

Job summary

  • Job post source

    This job is directly from Medical Review Institute of America, LLC (MRIoA).

  • Job overview

    The Utilization Review Work for Physicians role at MRIoA involves leveraging medical expertise to authorize healthcare services, impacting patient care and compliance with medical guidelines.

  • Responsibilities and impact

    The physician will review medical records using clinical guidelines, conduct peer-to-peer calls with providers, collaborate with internal teams, and ensure compliance with regulations and standards.

  • Experience and skills

    Candidates must have an MD or DO with board certification in Family or Internal Medicine, 5 years of recent patient care including 3 years inpatient hospital experience, strong computer literacy, and willingness to obtain multiple state licenses.

  • Work environment and culture

    MRIoA values integrity, professionalism, teamwork, and a structured work environment with scheduled shifts and dedicated focus during work hours.

  • Company information

    MRIoA, founded in 1983, is a leader in external medical review services with over 800 clients and nearly 600 employees, completing over 2 million reviews annually.

  • Job location and travel

    This is a full-time remote position requiring work within the United States and adherence to Mountain Time Zone scheduled shifts.

  • Unique job features

    The job requires strict adherence to scheduled shifts, multiple state medical licenses managed by the company, and a structured, compliance-focused work environment.

Company overview

Medical Review Institute of America, LLC (MRIoA) specializes in providing independent medical peer reviews and utilization management services to healthcare organizations, insurance companies, and government agencies. They generate revenue by offering expert medical opinions that assist in determining the necessity and appropriateness of medical treatments and services. Founded in 1983, MRIoA has established itself as a trusted partner in the healthcare industry, known for its commitment to evidence-based reviews and high standards of clinical excellence.

How to land this job

  • Tailor your resume to emphasize your MD or DO degree, board certification in Family or Internal Medicine, and at least 3 years of acute inpatient hospital experience, highlighting ICU experience if applicable.

  • Showcase your expertise in medical decision making, particularly your familiarity with MCG/InterQual guidelines, CMS policies, and your ability to apply clinical judgment in utilization review.

  • Highlight your strong computer literacy and your ability to work within structured schedules, demonstrating reliability and dedication to scheduled hours between 6:00am and 7:00pm Mountain Time.

  • Apply through multiple platforms including the Medical Review Institute of America's official career page and LinkedIn to maximize your application visibility and chances.

  • Connect with current employees or leaders within the utilization review or medical director divisions at MRIoA on LinkedIn. Use ice breakers like mentioning interest in their work on medical review standards or asking about their experience managing multiple state licenses.

  • Optimize your resume for ATS by incorporating keywords from the job description such as 'utilization review,' 'MCG/InterQual guidelines,' 'acute care,' 'medical decision making,' 'CMS regulations,' and 'board certification.'

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