Senior Medical Review Officer

About HireRight

HireRight is the premier global background screening and workforce solutions provider. We bring clarity and confidence to vetting and hiring decisions through integrated, tailored solutions, driving a higher standard of accuracy in everything we do. Combining in-house talent, personalized services, and proprietary technology, we ensure the best candidate experience possible. PBSA accredited and based in Nashville, TN, we offer expertise from our regional centers across 200 countries and territories in The Americas, Europe, Asia, and the Middle East. Our commitment to get it right every time, everywhere, makes us the trusted partner of businesses and organizations worldwide.

Overview

The Senior Medical Review Officer (MRO) serves as the organization’s senior medical authority for drug testing and occupational health review, ensuring all medical determinations are accurate, compliant, defensible, and consistent with federal, state, and client-specific requirements. 

In addition to medical review responsibilities, the Senior Medical Review Officer (MRO) serves as an industry subject matter expert, remaining current on emerging drug and alcohol trends, evolving testing methodologies, and regulatory guidance. The MRO may support client and industry education through activities such as webinars, presentations, training sessions, and written thought leadership related to drug testing, substance use trends, and occupational health best practices. 

The Senior Medical Review Officer (MRO) must be a licensed physician (MD or DO) and certified by the Medical Review Officer Certification Council and/or American Association of Medical Review Officers (MROCC and/or AAMRO) with expertise in controlled substance use disorders and a thorough understanding of alternative medical explanations for laboratory-confirmed drug test results. This includes knowledge of issues related to adulterated or substituted specimens, as well as potential medical causes of invalid test results. 

The Senior Medical Review Officer (MRO) is responsible for safeguarding the accuracy, integrity, and fairness of the drug testing process. Core duties include reviewing and interpreting non-negative test results and determining, through appropriate medical evaluation, whether legitimate medical explanations may account for such findings. A non-negative result alone does not establish illegal drug use by an employee or applicant. 

To ensure independence and objectivity, an MRO must not be employed by the testing laboratory unless a clear and documented separation of laboratory and medical review functions is maintained. 

Responsibilities

• Provide clinical leadership and mentorship to MROs and medical review staff. 

• Ensure strict adherence to chain-of-custody, confidentiality, and data integrity standards. 

• Provide executive oversight of Medical Review Officer (MRO) activities related to drug and alcohol testing. 

• Serve as the ultimate medical decision-maker for complex, escalated, or precedent-setting drug test result determinations. 

• Oversee interpretation and verification of laboratory test results, including donor interviews and prescription verification standards. 

• Establish, maintain, and update medical review policies, procedures, and clinical decision frameworks. 

• Lead quality assurance initiatives to ensure consistent, fair, and timely MRO determinations. 

• Partner with Compliance, Legal, and Operations to support audits, client inquiries, and regulatory reviews. 

• Act as a medical subject matter expert in disputes, appeals, and litigation support, as needed. 

• Monitor emerging trends in substance use, testing methodologies, and regulatory guidance to proactively adjust practices. 

• Comfort working with technology-enabled review platforms and data analytics. 

• Shall comply with all MRO requirements as specified in the DOT Procedures for Transportation Workplace Drug and Alcohol Testing Programs, 49 CFR Part 40. 

Qualifications

Education :

Licensed M.D. or D.O. by an applicable government authority and must be certified by the Medical Review Officer Certification Council and/or American Association of Medical Review Officers (MROCC and/or AAMRO)

Experience:

• Minimum 7 years of experience serving as a Medical Review Officer in drug and alcohol testing and occupational health environments. 

• Demonstrated experience performing independent medical review of non-negative drug test results, including donor interviews and prescription verification. 

• Extensive experience with DOT and non-DOT testing programs 

• Experience overseeing or supporting high-volume medical review operations, with an emphasis on accuracy, consistency, and turnaround time. 

• Proven experience participating in or supporting audits, regulatory inquiries, client escalations, or legal reviews related to drug testing results. 

• Demonstrated ability to apply sound medical judgment in complex, ambiguous, or precedent-setting cases. 

Knowledge & Skill: 

• In-depth knowledge of DOT, and applicable state and local drug testing regulations. 

• Comprehensive understanding of DOT and non-DOT drug and alcohol testing programs. 

• Knowledge of chain-of-custody requirements, confidentiality standards, and data integrity controls. 

• Familiarity with regulatory audit processes and compliance documentation requirements. 

• Demonstrates people leadership skills. 

• Expert knowledge of controlled substances, substance use disorders, and pharmacology relevant to workplace testing. 

• Understanding of drug metabolism, detection windows, cross-reactivity, and cutoff concentrations. 

• Knowledge of legitimate medical explanations for non-negative and invalid test results. 

• Understanding of specimen validity testing, including adulterated, substituted, diluted, and invalid specimens. 

• Knowledge of emerging drug classes and misuse trends (e.g., synthetic opioids). 

• Knowledge of laboratory testing processes and methodologies, including immunoassay screening and confirmatory testing (e.g., GC/MS). 

• Familiarity with alternative testing matrices such as oral fluid and hair testing. 

• Understanding of evolving testing technologies and regulatory guidance.

Scope of Impact: 

• Has full responsibility for the operational performance of sub-unit within a function. 

• Provides leadership to team leaders or supervisors. 

• Establishes criteria, formulates projects, and assesses effectiveness for projects with a significant business unit impact. 

• Has responsibility for assigning work, allocating resources, monitoring results, controlling costs and handling staff. 

• Manages the coordination of the activities of a section or department with responsibility for results, including costs, methods and staffing.

Strategic Planning:

• Makes decisions – guided by business unit or functional business plans – that impact the support and funding of projects, products, services and/or technologies. 

• Decisions are guided by resource availability and functional objectives. 

• Directs the resolution of complex or unusual technical, operational and organizational problems which may be multi-disciplinary. 

• Issues instructions on standard practices and policy application; follows up to determine compliance. Implements processes to produce desired changes in product line, function, or assigned area of responsibility.

Customer Focus:

• Develops relationships with key internal/external customers to identify emerging needs. 

• Effectively communicates difficult concepts by altering communication style to the audience. 

• Assimilates, synthesizes, discusses, and presents complex or sensitive information for discussion with more senior levels of management.

What do we offer

HireRight offers a competitive benefit package which includes:

• Medical
• Dental
• Vision
• Paid Life/AD&D Insurance
• Voluntary Life Insurance
• Short & Long Term Disability
• Flexible Spending Accounts
• 401K
• Generous Vacation and Sick Program
• 10 Paid Holidays
• Education Assistance Program
• Business Casual Attire
• Generous Referral Program
• Employee Discounts and Rewards
• And much more!
• All resumes are held in confidence. Only candidates whose profiles closely match requirements will be contacted during this search.

HireRight, LLC is an Equal Opportunity EmployerMinorities / Females / Veterans / DisabilitiesHireRight does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of HireRight and HireRight will not be obligated to pay a placement feeThis job description in no way states or implies that these are the only duties to be performed by a team member’s occupying this position. Team members may be required to perform other related duties as assigned, to ensure workload coverage. Team members are required to follow any other job-related instructions and to perform any other job-related duties requested by their supervisor. This job description does not constitute an employment agreement between the employer and team member and is subject to change by the employer as the organizational needs and requirements of the job change. This job description is subject to change at any time.