Medical Director – Utilization Management

Medical Review Institute of America, LLC

Medical Director, also known as Physician Advisor, managing clinical utilization and peer reviews in a remote work environment. Ensuring clinical quality management and collaboration across different departments.

Posted 6/10/2026full-timeRemote • 🇺🇸 United StatesLead💰 $240,000 per yearWebsite

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

utilization managementcase reviewsinter-rater reliability testingclinical carepeer review programsstate licensuremedical licenseboard certification

Soft Skills

productivity maintenancequality score maintenancetrainingtimelinessrespectful communicationparticipation in meetingsidea contributionwillingness to take cases

Certifications & Qualifications

MD degreeDO degreeunrestricted medical licenseboard certification by ABMSboard certification by AOA

Industry Keywords

regulatory requirementsaccreditation standardsclinical practiceMRIoAcredentialing

About the role

Key responsibilities & impact

Perform utilization management case reviews.
Maintain productivity score per company standard.
Maintain annual quality score per company standard.
Complete annual inter-rater reliability testing.
Train across all queues as requested by MRIoA leadership.
Complete all client specific training as requested by MRIoA leadership.
Maintain up-to-date records of case completion if required.
Consistently show willingness to take cases as requested.
Demonstrate respect in interactions across the company.
Consistently submit scheduling requests at least three months in advance.
Consistently work scheduled hours.
Provide ideas for promotion and growth of the company as requested (i.e. contribute to the vision of the company).
Respond appropriately and in a timely manner to licensing/CME requests from the Senior Medical Directors, Vice President of Medical Affairs, or Chief Medical Officer and/or administrative team.
Actively participate in the MRIoA evaluation process (both company and individual).
Participate in all company meetings and committees as requested.
Complete other duties as requested or approved by the CEO and/or chief medical officer.
Thorough understanding of the Company’s clients, products, departments, workflows, and applicable regulatory requirements and accreditation standards

Requirements

What you’ll need

Minimum of five years’ full-time equivalent experience providing direct clinical care to patients
Minimum of five years’ experience administering utilization management and peer review programs preferred
Credentialed and privileged by the Company's Credentialing Committee
Obtain additional state licensure as required for the position
Education: MD/DO degree
Current, unrestricted medical license as required for clinical practice in a state of the United States
Board certification by a medical specialty board approved by the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA) or other board recognized by URAC preferred

Benefits

Comp & perks

healthcare, vision, and dental insurance
A generous 401(k) match
Paid vacation, PTO, and holidays
Growth and training opportunities
An award-winning remote work environment