Medical Review Institute of America, LLC

Role Description We are currently seeking Board-Certified physicians in Nephrology to conduct independent Utilization Reviews. This is a flexible, fully remote opportunity requiring just 1–2 hours per week—with no minimum commitment. - Work remotely from anywhere in the US (Per HIPAA Regulations, patient records cannot leave the US). - Covered under MRIoA's Errors and Omissions policy. - Independent Contractor (1099) opportunity. - Workers are required to adhere to all applicable HIPAA regulations and company policies and procedures regarding the confidentiality, privacy, and security of sensitive health information. Qualifications - Must have a Medical Degree MD or DO. - Must have a current TEXAS state medical license. - Current Board Certification in Nephrology. - Must have 5 years of clinical experience (residency to be included). - Daytime availability is required for peer-to-peer conversations. Requirements - Must have a Medical Degree MD or DO. - Must have a current TEXAS state medical license. - Current Board Certification in Nephrology. - Must have 5 years of clinical experience (residency to be included). - Daytime availability is required for peer-to-peer conversations. Benefits - Flexible, fully remote opportunity. - Covered under MRIoA's Errors and Omissions policy.

• Conduct independent Utilization Reviews • Work remotely from anywhere in the US • Adhere to all applicable HIPAA regulations and company policies regarding confidentiality

• partner with key members of leadership for the design and implementation of Quality Management procedures • ongoing improvement efforts, and other team projects with the aim of achieving organizational, accreditation, and regulatory requirements • Review and analyze current processes related to the application and implementation of policies, procedures, and practices • provide leadership with recommendations for updates to comply with the current regulatory and accreditation requirements • Identify gaps in efficient process workflow and suggests steps for quality process improvement • Measure process performance using valid and accurate methods; analyze trends, variation, and process stability to determine if defined performance metrics are met and identify areas of risk • lead and support structured quality improvement initiatives (e.g. DMAIC or equivalent) • Manage and lead Quality Improvement Projects (QIPs) • Manage and ensure execution of CAPAs, including documented root cause analysis, defined success metrics, implementation tracking, and post-implementation validation demonstrating sustained improvement in coordination with the Clinical Quality, Compliance, and Operations leaders • Serve as liaison between clients and MRIoA’s quality management department as needed • Assist leadership in establishing and reporting quality metrics

• Manager-level position responsible for end-to-end operational oversight of pharmacy operations supporting both clinical and non-clinical functions • Accountable for workflow performance, team coordination, and execution across integrated operational models • Leads cross-functional teams responsible for case progression, clinical review support, and completion activities, ensuring alignment with quality, turnaround time, and productivity expectations • Partners with clinical leadership, quality, and operations teams to drive efficiency, reduce rework, and support scalable, high-performing operational workflows • Provide operational leadership for pharmacy operations workflows, including both clinical and non-clinical functions supporting IRO services (initial reviews and appeals) • Own the execution and performance of integrated pharmacy operations, ensuring alignment across case progression, clinical review support, and completion processes • Lead cross-functional teams to deliver against key operational metrics, including quality, turnaround time, productivity, and backlog management • Drive alignment between clinical and non-clinical workflows to ensure efficient case flow, minimize rework, and optimize resource utilization • Partner with clinical leadership, quality, and operations teams to ensure consistency in review practices, documentation standards, and workflow execution • Contribute to the ongoing design, refinement, and standardization of operational workflows to support scalability and performance improvement • Develop team capability through coaching, performance management, and workforce planning across both clinical and non-clinical staff • Identify operational risks, gaps, and inefficiencies, and implement solutions to improve performance and service delivery • Lead day-to-day operations of pharmacy workflows, ensuring efficient case progression across clinical and non-clinical functions • Own performance outcomes for assigned operations, including quality, turnaround time, productivity, and backlog management • Monitor and manage workflow distribution, capacity, and staffing to ensure alignment with volume demands and service level expectations • Ensure effective coordination between clinical and non-clinical functions to support seamless case flow and minimize delays or rework • Identify and resolve operational bottlenecks, inefficiencies, and breakdowns in workflow execution • Establish and maintain performance standards, ensuring accountability at both individual and team levels • Provide direct leadership to team members, including coaching, performance management, and development of both clinical and non-clinical staff • Partner with quality and clinical leadership to ensure consistency in review practices, documentation, and adherence to internal and external standards • Support implementation and stabilization of new workflows, processes, and operational changes to improve efficiency and scalability • Analyze operational data and performance trends to identify opportunities for improvement and drive informed decision-making • Ensure readiness and operational alignment for new clients, products, or workflow changes impacting pharmacy operations • Maintain effective communication with cross-functional partners to ensure alignment on priorities, risks, and performance outcomes • Perform other duties as required to support operational performance and business needs

• partner with key members of leadership for the design and implementation of Quality Management procedures, ongoing improvement efforts, and other team projects • lead and support structured quality improvement initiatives (e.g., Lean, Six Sigma, DMAIC or equivalent) • review and analyze current processes related to the application and implementation of policies, procedures, and practices • provide leadership with recommendations for updates to comply with the current regulatory and accreditation requirements • identify gaps in efficient process workflow and suggests steps for quality process improvement • measure process performance using valid and accurate methods • analyze trends, variation, and process stability to determine if defined performance metrics are met • manage and lead Quality Improvement Projects (QIPs) • serve as liaison between clients and MRIoA’s quality management department • assist leadership in establishing and reporting quality metrics

• staff-level software engineer responsible for designing, developing, and maintaining modern web applications using full-stack technologies • Develop, maintain, and deploy full-stack web applications • Build user interfaces using React and modern frontend technologies • Develop backend services using NodeJS and Python (APIs, microservices) • Support application hosting, server management, and deployment pipelines • Utilize AI-assisted coding tools to enhance development efficiency and quality • Design, implement, test, document, and maintain software applications aligned with coding standards and industry best practices • Develop scalable APIs and backend services using NodeJS and Python • Build responsive, accessible UI components using React • Collaborate with stakeholders to define system scope, requirements, and design solutions • Document, investigate, prioritize, and resolve software defects • Monitor, analyze, and enhance application performance and reliability • Contribute to CI/CD pipelines, automated testing, and DevOps practices • Research and recommend improvements to tools, frameworks, and development processes • Ensure adherence to security, privacy (PHI/HIPAA), and compliance standards

• 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

• responsible to carry out day-to-day departmental tasks and complete all processes for screening incoming pharmacy review requests • preparing review information and materials for assignment to appropriate reviewers • entering pharmacy case review data in the online case summary/tracking system • receiving and reviewing Reviewer decisions • completing outreach over the phone to gather additional information for cases • taking inbound phone calls from medical professionals • issuing appropriate, timely and accurate review outcome notifications • completion of pharmacy case review data in the online case summary/tracking system and client system • To prepare high quality appropriate pharmacy case review information and materials for submission to the reviewers • To finalize the pharmacy case review process and issue review outcome notifications to appropriate parties of the case • To serve as a company liaison with clients, reviewers and practitioners/providers/facilities whose services are subject to review • Screen incoming pharmacy review requests for completeness of materials required to conduct the review of the case • Prepare, organize, distribute and present records, materials and forms required for a complete pharmacy case review by reviewers • Identify appropriate reviewers for pharmacy case review assignment including: determine their availability for a review assignment and obtain information for delivery of the case to the Reviewer if applicable • Contact clients to resolve questions, obtain information, records and/or materials needed for a pharmacy case review and resolve issues about active cases • Respond to reviewers’ requests for additional information/materials necessary for a review and notify clients and other internal departments of these needs, as applicable • Complete outreach via fax and over the phone to obtain missing information necessary to issue appropriate clinical decisions • Receive incoming phone calls from medical professionals checking status on cases and/or providing additional information to decision cases • Create and maintain an in-house review file for each active pharmacy case • Respond to inquiries from clients, other entities referring pharmacy cases for review and practitioners/providers/facilities • Issue oral and written review outcome notifications that comply with standards and requirements for timeliness, content, recipients and accuracy including written notification grammar and spelling as needed • Research clients’ questions about review processes and/or Reviewer decisions • Determine the need for additional information or additional review and notify the client and internal departments of these needs • Support all Quality Management initiatives • Actively participate in the compliance process and Provider Relations assessment process • Support all compliance program activities • Participate in all company meetings and committees as requested • Adhere to all policies and procedures • Take feedback and responsibility for performance • Adapt to the differences of clients • Maintain a flexible schedule to meet client needs • Complete other duties and responsibilities as directed • Collaborate with and cross-train on other teams as needed

• Drive project management execution using established best practices to facilitate the business meeting organizational goals. • Guides, mentors, and evaluates internal project team performance within project guidelines • Creates and executes Project plans and revises appropriately to meet changing requirements and needs • Plans and schedules Project timelines and milestones using standard project management tools. • Communicates milestones, timelines, and obstacles throughout the organization • Manages day-to-day operational and tactical activities of a Project • Defines the need of resources and works to obtain the needed resources to ensure project completion • Able to balance priorities and resources to achieve organizational and individual goals • Successfully engages in multiple initiatives simultaneously • Shows ability to learn new tools and processes • Ability to hold the team accountable for hitting deadlines • Evaluates and reports project outcomes or concerns • Ensures follow-up with team members to continue to drive projects

• Responsible for participating in development and implementation of corporate-wide marketing and sales activities • Build funnel with leads for clinical review services in the health, pharmacy, third-party administrator, Taft- Hartley plans, employer self-insured, disability and worker’s compensation industries. • Partners with commercial sales and marketing teams to develop sales opportunities and grow funnel • Assist Customer Success reps in developing strong customer relationships, meets and exceeds sales targets, and provides world-class customer support • Partner with regional sales representatives to search out new sales opportunities through new clients or new opportunities with existing clients • Assist in developing a business strategy to maximize opportunities for clinical service offerings in health, pharmacy and other specialty areas of focus • Achieve sales target and funnel growth volumes • Advance sales funnel opportunities by scheduling initial sales calls based on assigned geography, developing new contacts/relationships, and coordinating remote/onsite qualified appointments with sales representatives.