Medical Review Institute of America, LLC

Sales

• Responsible for growing sales in excess of 20% annually through long-term planning and execution.
• Build long-lasting relationships with Health Plans, Value-based providers, PBMs, TPA’s, Self-Insured Employers, and other healthcare payer organizations.
• Partner with customer success, clinical, and operations teams to focus on revenue growth, customer satisfaction metrics, and profitability.
• Direct lead generation and sales activities to impact new business growth.
• Manage the entire end-to-end sales process, from lead generation to pipeline management through deal execution and enablement of implementation.
• Maintain key client relationships and expand the current client portfolio.
• Prepare and perform all product demonstrations and presentations to key stakeholders.
• Collaborate with clinical support, product management, inside sales, and account management during the sales process.
• Provide feedback and input for marketing/product/service enhancements.

Vice President of Sales – Strategic Accounts

Medical Director

• Conduct coverage reviews using critical thinking and clinical expertise, based on individual patient/member benefits and national or proprietary coverage review policies.
• Interpret benefit language and policies to guide clinical coverage determinations.
• Document clinical review findings and outcomes in compliance with organizational, regulatory, and accreditation standards.
• Engage in peer-to-peer consultations with prescribing providers when appropriate.
• Collaborate and communicate effectively with fellow Medical Directors.

Utilization Review Medical Director

AI Engineer

• Lead design, development, and deployment of AI/ML solutions across the enterprise
• Collaborate with business, operations, and technology teams to define AI use cases and align delivery timelines
• Partner with internal teams and third-party vendors to develop efficient, compliant, and scalable AI systems
• Lead rapid prototyping efforts to demonstrate value and inform broader adoption
• Research, design, and implement machine learning models (supervised, unsupervised, reinforcement learning), including deep learning and NLP
• Conduct data preparation, cleansing, and feature engineering
• Train, validate, and fine-tune models to optimize performance and accuracy
• Build reusable, production-ready pipelines for AI model deployment using MLOps best practices
• Integrate AI/ML capabilities into existing products and platforms with application development teams
• Design and implement testing and evaluation frameworks for model validation; monitor and maintain deployed models
• Ensure AI systems are secure and compliant with regulatory standards (e.g., HITRUST, SOC 2, HIPAA)
• Support transition of business processes to AI-driven solutions with documentation, training, and retrospectives
• Work remotely from home using standard office equipment as required

AI Developer, Healthcare

Artificial Intelligence

• Translate business and clinical requirements into machine learning use cases focused on automation, decision support, and risk prediction in the utilization management domain
• Adapt and optimize existing machine learning techniques—including classification, NLP, and time series modeling—to address specific operational workflows and data structures
• Collaborate with developers to rapidly prototype and iterate on ML models with a focus on production-readiness, scalability, and integration into customer-facing products
• Contribute to the design of intelligent services (e.g., automated prior authorization, clinical rule learning, denial prediction) that directly impact product capabilities
• Collaborate with data engineers to acquire, preprocess, and structure healthcare data from diverse sources (claims, EHR, clinical notes)
• Perform data wrangling and feature engineering to enable robust modeling pipelines
• Evaluate and tune model performance using business-relevant metrics (e.g., precision, recall, F1, ROI), ensuring alignment with product goals and customer needs
• Partner with product managers, designers, and software engineers to embed ML capabilities into digital products and decision support tools
• Develop documentation, model APIs, and integration specifications to support seamless model deployment in production systems
• Provide insights and recommendations to support product roadmap decisions and feature prioritization
• Ensure ML solutions are reliable, maintainable, and explainable, implementing monitoring and retraining strategies to maintain performance and adapt to data drift
• Align development with healthcare compliance requirements (HIPAA, HITRUST, SOC 2) and promote ethical use of AI
• Stay up to date with emerging research in ML and health AI and conduct competitive analysis of commercial and open-source AI/ML tools
• Contribute to internal knowledge sharing and build a culture of applied innovation and product-driven development

AI/ML Scientist – Healthcare

Frontend Engineer

• Design, implement, test, document, and maintain software applications according to existing guidelines, coding standards, and industry best practices.
• Assist stakeholders in defining scope and specifications for new software solutions by studying business requirements, work processes, and data usage.
• Document, investigate, fix, and report on software defects.
• Monitor, analyze, refactor, and enhance existing apps and source code.
• Research and recommend improvements to our software, processes, and development tools, including cost and time estimates.
• Complete other duties as requested

Vice President of Sales – Strategic Accounts

Utilization Review Medical Director

AI Developer, Healthcare

AI/ML Scientist – Healthcare

Web Developer (Remote)