Medical Review Officer (MRO) - Bid
Maximus
Dover, DE (In Person)
$291,500 Salary, Full-Time
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Job Description
- Please note that this position is contingent upon bid award
Essential Duties and Responsibilities:
- As a physician consultant, access a secure portal to retrieve and work clinical cases; review each set of case records for the clinical history, diagnoses, current symptomatology, and current requested treatment(s).
- Research patient records for any relevant information consistent with the requested treatment(s) to obtain an accurate clinical picture of the status of the condition(s) present.
- Access the online version of the evidence-based state guidelines to decide which guideline pertains to the requested treatment, and then determine if there are associated criteria or circumstances when the requested medical treatment is appropriate.
- Analyse and compare the guideline to the pertinent case records to determine if the case meets, or does not meet, the criteria for the requested treatment.
- In cases where no state guideline pertains to the requested treatment, the physician must research for other approved secondary sources of peer-reviewed literature to support the decision, and then review and interpret that scientific literature to determine if it supports, or doesn't support, the requested treatment in that respective case.
- After completing all research, the physician must write a case rationale in the correct format that introduces the question at hand, summarizes the correct guideline, analyses the pertinent case details related to the guideline, and then make a final determination as to the medical necessity of the requested service.
- Serve as the designated Medical Review Officer (MRO) for drug and alcohol testing conducted within job readiness and Drug‑Free Workplace Program (DFWP) activities.
- Review and interpret laboratory test results to determine compliance and accuracy in accordance with federal and program standards.
- Conduct medical assessments or obtain additional medical information from participants when necessary to determine if there is a legitimate medical explanation for test results.
- Document all evaluations and final determinations in compliance with regulatory and program requirements.
- Ensure timely reporting of verified results to authorized program or case management personnel.
- Maintain strict confidentiality and adherence to HIPAA and other applicable privacy laws.
- Stay current with HHS, DOT, and other regulatory guidelines governing MRO responsibilities.
- Provide updated proof of all required licenses and certifications at proposal submission and at required six‑month intervals.
- Collaborate with program leadership or testing vendors to address result discrepancies, regulatory questions, or process improvements. Minimum Requirements
- Bachelor's Degree and minimum of 12 years of experience required.
- Must be an MD or DO with an active license to practice medicine with no disciplinary history.
Medical License:
Permanent, full, and unrestricted license to practice medicine in a U.S. jurisdiction.Board Certification:
Board certified Doctor of Medicine (MD) or Doctor of Osteopathy (DO).Experience:
o Minimum of five (5) years of experience providing MRO services to Drug Free Workplace Programs. o At least three (3) of those years within the last three (3) years of this requirement.Certification:
o Current HHS approved MRO certification, provided at time of proposal and at six-month intervals thereafter. o Current medical board certification, also provided at time of proposal and at six-month intervals.- Strong knowledge of federal drug testing regulations and MRO protocols.
- Excellent analytical, communication, and documentation skills.
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