The Director of IRO Services leads the strategy, operations, and regulatory integrity of the organization's Independent Review Organization and Utilization Review service line. This role manages the full case lifecycle, ensures regulatory compliance, and oversees cross-functional partnerships with clinical and client-facing teams.
The Clinician Reviewer conducts independent, evidence-based medical necessity reviews for LTSS, PAS, and IHSS appeals. They are responsible for rendering clinically sound, defensible determinations based on functional assessments and state-specific regulatory guidelines.
You will lead the development and execution of RediMinds' federal healthcare growth strategy, focusing on building a robust pipeline and securing major technology contracts. This involves establishing strategic partnerships, shaping procurement opportunities, and building a repeatable federal business engine from the ground up.
