Pediatric Pulmonology Utilization Reviewer – Texas Licensed

Medical Review Institute of America, LLC

. Conduct independent Utilization Reviews .

Posted 11/3/2026contractRemote • Texas • United StatesMid-LevelSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in conducting Utilization Reviews and peer-to-peer conversations while ensuring compliance with HIPAA regulations. Possesses extensive clinical experience in Pediatrics and Pulmonology, emphasizing patient confidentiality and security of health information.

Highest-signal resume keywords

Medical Degree MD Or DOCurrent Texas Medical LicenseBoard Certification In PediatricsFellowship Trained In Pulmonology5 Years Of Clinical Experience

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ReviewPeer-To-Peer ConversationsPatient Record ReviewCompliance With HIPAA Regulations

Soft Skills

Daytime Availability

Certifications & Qualifications

Board Certification In Pediatrics

Industry Keywords

ConfidentialityPrivacySecurity PoliciesSensitive Health Information

About the role

Key responsibilities & impact

Conduct independent Utilization Reviews
Participate in peer-to-peer conversations during daytime availability
Review patient records while complying with HIPAA regulations and confidentiality, privacy, and security policies

Requirements

What you’ll need

Must have a Medical Degree MD or DO
Must have a current Texas medical license
Current Board Certification in Pediatrics
Fellowship trained in Pulmonology
Must have 5 years of clinical experience, residency to be included
Daytime availability is required for peer-to-peer conversations
Must adhere to all applicable HIPAA regulations and company policies and procedures regarding confidentiality, privacy, and security of sensitive health information

Benefits

Comp & perks

Flexible independent contractor (1099) opportunity
Fully remote work opportunity
No minimum commitment
Covered under MRIoA's Errors and Omissions policy