Vice President of Medical Affairs (Fully Remote)

Description

About MRIoA

The Medical Review Institute of America, LLC (MRIoA), was incorporated in 1983. Today, we are an industry leader that provides external review resources to over 800 clients nationwide and completes more than 1.9 million reviews annually.

At MRIoA, we believe our employees are the key to our success. Here, you are more than just a cog in the machine. You are a valued member of our team of over 500 employees.

We Offer

• A competitive compensation package.
• Our comprehensive benefits package is designed to support your overall well-being. It includes healthcare, vision, and dental insurance.
• Generous 401k match.
• Paid vacation, paid sick leave, and paid holidays.
• A company that is recognized as one of USA Today's Top Workplaces.

Position Overview:

As the Vice President of Medical Affairs, you will be pivotal in providing executive leadership and strategic direction to our medical review operations. You will oversee a team of medical directors and staff, ensuring the delivery of efficient, timely, and clinically sound review services. Your expertise in healthcare management and clinical practice will drive the success of our organization as we continue to uphold the highest standards of medical review excellence.  

This role is a Senior Leadership position responsible for all Medical Director Operations, including all MD productivity and utilization improvements for profitability between lines of business, staffing, and physician engagement. You will be an EMT (Executive Management Team) member driving executive-level decision-making. Also active in clinical utilization management, peer review activities, and clinical quality management activities. In addition, this position is assigned the responsibility for specific clients serviced by the internal medical director team with responsibilities to include assisting in the training of medical directors for assigned clients, ensuring proper auditing of medical directors for assigned clients, and attending client meetings as determined by the CMO of Clinical Operations.   

Primary Responsibilities or Assigned Duties: 

Leadership and Strategic Direction: 

• Provide visionary leadership to the medical director team, fostering a culture of accountability, collaboration, innovation, and excellence. 
• Develop and implement strategic initiatives to enhance operational efficiency, quality improvement, and client satisfaction. 
• Collaborate with senior leadership to align medical review operations with organizational goals and objectives. 

Clinical Oversight and Quality Assurance: 

• Oversee the medical review process for internal Medical Directors to ensure adherence to clinical guidelines, regulatory requirements, and best practices. 
• Conduct regular reviews of medical review cases to assess quality, accuracy, and consistency. 
• Liaison with quality, compliance, and operational teams to Implement quality improvement initiatives based on data analysis and stakeholder feedback. 

Team Management and Development: 

• Recruit, train, and mentor a high-performing team of medical directors and clinical staff. 
• Provide ongoing performance feedback, coaching, and professional development opportunities. 
• Foster a culture of accountability, collaboration, and continuous learning within the medical directorate. 

Client Engagement and Relationship Management: 

• Serve as a trusted advisor to clients when requested, providing clinical expertise, insights, and recommendations. 
• Collaborate with business development and account management commercial teams to understand client needs and develop customized solutions. 
• Proactively address client concerns, resolve issues, and ensure high levels of client satisfaction. 

Regulatory Compliance and Risk Management: 

• Stay abreast of changes in healthcare regulations, accreditation standards, and industry trends. 
• Ensure compliance with applicable laws, regulations, and accreditation requirements. 
• Develop and implement risk mitigation strategies to minimize legal and regulatory risks.  
• Complete performance management responsibilities for the team, including preparing performance reviews, providing Medical Directors with quality and performance feedback, and administering Performance Improvement and Corrective Action Plans as needed. 
• Attend assigned client meetings. 
• Assist the Chief Medical Officer of Clinical Operations in achieving the department and company's annual goals and objectives as determined by the CMO and CEO. 
• Perform utilization management case reviews. 
• Complete annual inter-rater reliability testing. 
• Demonstrate respect in interactions across the company. 
• Provide ideas for promotion and growth of the company as requested (i.e., contribute to the company's vision). 
• Actively participate in the MRIoA evaluation process (both company and individual). 
• Participate in all company meetings and committees as requested. 
• 20-25% of time spent in the production of Utilization Management cases. 
• Complete other duties as requested or approved by the CEO and/or Chief Medical Officer. 

Requirements

Education, Certifications, and Licenses:

• MD/DO degree.  
• Current and 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), the American Osteopathic Association (AOA), or another board recognized by URAC preferred, Family Medicine or Internal Medicine preferred. 

Skills and Experience:

•  Minimum of five years of full-time equivalent experience providing direct clinical care to patients. 
• Minimum of seven years experience administering utilization management and peer review programs with executive experience leading large teams across a multi-matrix corporation. 
• Demonstrated leadership experience in healthcare management, preferably in a managed care, insurance, or healthcare consulting setting. 
• Proven track record of strategic planning, operational excellence, and performance improvement. 
• Excellent interpersonal, communication, and relationship-building skills with a proven track record of cross-functional collaboration, negotiation, and leveraging influence to accomplish mutually beneficial objectives. 
• Strong analytical skills with the ability to interpret complex medical information and business/performance data. 
• Knowledge of healthcare regulations, compliance requirements, and accreditation standards. 
• Ability to thrive in a fast-paced, dynamic environment and lead change initiatives effectively. 
• Credentialed and privileged by the company's credentialing committee. 
• Thorough understanding of the company's clients, products, departments, workflows, and applicable regulatory requirements and accreditation standards. 
• Obtain additional state licensure as required for the position. 

Work Environment: 

Ability to sit at a desk, utilize a computer, telephone, and other basic office equipment is required. This role is designed to be a remote position (work-from-home). 

Diversity creates a healthier atmosphere: All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

This company is a drug-free workplace. All candidates are required to pass a Background Screen before beginning employment. All newly hired employees will take a Drug Screen and agree to all necessary Compliance Regulations on their first day of employment.