700

PHYSICIAN AND ALLIED HEALTH REVIEWERS

150

SPECIALTIES

35

MDs/DOs ON STAFF

20

INTERNAL SPECIALISTS

40

NURSES ON STAFF

60

PHARMACISTS ON STAFF

PHYSICIAN LICENSURE IN ALL 50 STATES

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ABOUT MRIoA

Founded in 1983, Medical Review Institute of America, LLC (MRIoA) is the top medical review company in the United States. With the largest, most extensive review network, industry-leading turnaround times (TATs), and UR licensing in all states that require it, our professionalism, enthusiasm and collaborative approach are transforming clinical care delivery nationwide.

MRIoA provides independent clinical and utilization reviews, virtual second opinions and appropriate utilization analytics for many of the country’s largest health plans, PBMs, TPAs, government entities and self-insured employers.

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MRIoA has always been my first choice for peer reviews, UCR assistance, and plan language interpretation regarding clinical. The reviews are easily understood, and the clinicians always answer all questions that are posed for review.

- Supervisor at a Nationwide TPA

I have always had a great experience with MRIoA. The staff members are the experts in their positions. Absolutely one of the best companies for communication and problem solving and correcting/clarifying outcomes. Always receive updates and the staff is wonderful to work with.

- Case Manager at a Medical Management Organization

Management is responsible for employee attitudes. Your employees have been nothing but professional, friendly, and always aim to respond to my questions in a timely manner. I appreciate that every bit as much as I appreciate the quality of the reviews. Kudos to management and kudos to staff.

- Claims Specialist at an Insurance Provider

Your staff is extremely easy to work with, gracious, follows up appropriately, and responds quickly. It's wonderful to work with your company in an age where customer service is dead/dying! I have always been a strong advocate of excellent CS, so it's great to see elsewhere! I'm very happy with the review process and format in which the review is provided.

- Claims Manager at an Insurance Benefit Administration Company

Positive attitude, turnaround time and completeness of reviews. I truly appreciate our relationship with your company. I have been very impressed with overall responsiveness and the ability to develop unique solutions for customers without a great deal of hassle for the customer.

- Director of Medical Management at a Non-profit Health System

ENSURING COMPLIANCE AT EVERY STEP

MRIoA holds dual URAC accreditations in Health Utilization Management and Independent Review Organization, as well as accreditation by NCQA in Utilization Management and security certification by HITRUST.

The MRIoA Compliance Program proactively tracks applicable state and federal laws and regulations and identifies and resolves issues to ensure compliance.

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THE MRIoA WAY

At the heart of everything we do at Medical Review Institute of America is a set of principles called The MRIoA Way. These core principles drive every aspect of our work, helping us maintain premier customer service standards and maximize quality, efficiency and value to our clients.

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MRIoA’S EXECUTIVE TEAM

RON SULLIVAN

Chief Executive Officer

Ron Sullivan

Ron attended North Central College in Chicago for liberal arts and then the University of Minnesota where he earned a BS in Mechanical Engineering. His career started in the power industry with Westinghouse Electric Corporation in application engineering & sales followed by several years in a variety of leadership and general management positions with GE’s Power business and the American Superconductor Corporation. In 2001, he rejoined GE in their Healthcare business, and for the next 15 years, held roles ranging from VP of Global Services Marketing, GM Consulting Services, VP of Quality Operations and Global Lean/Six Sigma as well as a Vice President in the Global GE Surgery business. Following GE, Ron transitioned to lead the Global eCOA Clinical Trials Business for ERT as the Executive Vice President and Product Line Executive prior to joining MRIoA as the CEO in 2018.

BILL LOW, MBA

Founder

Ron Sullivan

Bill joined MRIoA in 1992 while a college student at the University of Utah. His first job with MRIoA was as the company courier delivering medical files to physicians who at that time were primarily located in the Salt Lake Valley. In 1996, after graduation, he left the company and joined a national firm as a sales representative and was quickly promoted to sales manager after reaching the presidents club his first year in sales. He was later promoted to branch manager. This company gave him the exposure of working for a large national firm in multiple markets.

In 2001 Bill returned to MRIoA as a national marketing representative with the primary responsibility of growing the company business. He is credited with bringing on many of MRIoA’s largest accounts today. In 2006 Bill was appointed President. In his current role, he has oversight responsibilities for all corporate operations including product offerings, review quality, regulatory compliance, provider relations, human resources and sales/marketing. Most importantly, he ensures his vision for corporate culture, customer service and high quality is fully embraced by the employees. Bill spends much of his time traveling, meeting with clients and prospects to make sure MRIoA designs products that best serve the clients’ needs.

Bill has an Executive MBA and Bachelor of Science degree in Communications, both from the University of Utah. He also serves on the Board of Directors for the Better Business Bureau in Salt Lake City. He resides in Bountiful, UT with his wife Shirley – whom he met when she was working for MRIoA in 1992 – and their 5 children. Most of his free time is spent with his family. He especially enjoys watching his children participate in a variety of sports and other activities.

DONALD MURPHY, MS, CISSP, HCISPP

Chief Technology Officer

Ron Sullivan

Don received his BS in Mechanical Engineering from Worcester Polytechnic Institute (WPI). He moved to Utah from the east coast to attend the University of Utah where he earned a MS in Mechanical Engineering with a specialty in Controls Systems and Artificial Intelligence. While completing his MS, he worked for a consulting engineering firm where he also earned his Professional Engineering (PE) license in control systems for the state of Utah.

His experience and background gave him the opportunity to work for a startup company in Salt Lake City as the VP of Engineering developing and applying artificial intelligence process control applications. When market conditions led to the dissolution of the company, Don leveraged his computer skills and became a freelance programmer.  A short-term assignment in the fall of 2000 with Medical Review Institute of America, at the time a small company who needed a little programming support, quickly turned into a 20+ year career as head of Information Technology.

As part of this role, Don also became responsible for Information Security at MRIoA. He earned his Certified Information Systems Security Professional (CISSP) credentials to add value to the organization and maintain HIPAA compliance and security at all levels.  Don and his family thoroughly enjoy owning a home in Utah for the ski life and vacationing in warmer climates to take on his other passions of mountain bike, Golf, and the overall love of the outdoors.

DR. RICHARD GASCOIGNE

Chief Medical Officer

Richard Gascoigne

Dr. Richard Gascoigne, has been named Chief Medical Officer – Medical Director, Operations. Richard has been with MRIoA for 10 years, 5 of those being in leadership positions. He is responsible for onboarding and ensuring the success of newly hired physicians and is accountable for making sure the utilization clinical guidelines are followed providing safer, quality care.

Dr. Gascoigne is a board-certified Family Medicine Doctor with over 23 years of experience in the medical field.  He received his medical training at Wayne State University School of Medicine then went on to earn an MBA from Gonzaga University. Dr. Gascoigne also served as a Naval Flight Officer in the United States Navy after graduating from Michigan State University.

DR. RODNEY MUSSELMAN

Chief Medical Officer

Dr. Rodney Musselman

Dr. Rodney Musselman joined MRIoA in May 2013 as a medical director and now serves as the Chief Medical Officer – Commercial and Innovation. He provides clinical leadership to drive the expansion of clinical solutions and growth of MRIoA. Dr. Musselman is also involved with the clinical quality management activities of the company.

Prior to joining MRIoA, Rodney completed his undergraduate and medical training at Indiana University School of Medicine and became board certified in Family Medicine in 2003. Dr. Musselman was in clinical practice as a family doctor for 10 years before joining MRIoA.

Sally Newton, SPHR, SHRM-SCP

Vice President of Human Resources

Sally Newton

Sally has over 20 years of experience in human resources and has been with MRIoA for over 4 years.  She was hired as a director and was promoted to Vice President while growing our human resources department to what it is today. Sally is responsible for the creation and maintenance of the MRIoA Academy including all the training and curriculum. In her free time, she and her husband, Art, enjoy spending time with their goddaughters and dogs.

Nicole Lomeli, PharmD

Director – Operations, ESI

Nicole Lomeli

Nicole has been in the healthcare industry since 2005, and as a licensed pharmacist since 2014. She joined MRIoA in 2019 to continue her passion for building high performing teams that drive patient-centered outcomes.  Nicole continues to grow in her role here at MRIoA, from starting on prior authorizations to the Director of Operations, ESI. Nicole has a passion for mentoring others and building strong leaders.  You can find Nicole enjoying her free time with her husband and young son while exploring local attractions.

Rene Lomeli, PharmD

Director – Operations

Rene Lomeli

Rene has been with MRIoA for over 5 years and is a Clinical Pharmacist with background in utilization review, hospital, and community practice. He is a strategic planner and forward thinker with a focus on patient care, customer service, and delivering results. Rene is well versed with current guidelines, trends, healthcare technologies and metric-driven opportunities. His motto is: Let’s work smarter, not harder.

RANDY ISKOWITZ

Chief Revenue Officer

Ron Sullivan

Randy has over 25 years of sales and sales leadership experience with the payer, provider and government markets at regional, national and international levels. Prior to joining MRIoA, Randy held senior sales and sales leadership positions at MCG (formerly Milliman Care Guidelines), The TriZetto Group, McKesson Corporation and Milliman, including others.

As Chief Revenue Officer at MRIoA, Randy is responsible for driving revenue growth, marketing and customer retention.

Randy is known as a transformational leader and a results-oriented professional that follows the principles of the Ideal Team Player written by Patrick Lencioni – Hungry, Humble and Smart. He also works closely with his teams and MRIoA customers to ensure that MRIoA provides trusted clinical guidance to enable the right decisions for patients while reducing overutilization costs across the healthcare landscape.

When Randy is not at work, he likes to find ways to give back to the community and cheer on his alma mater, The University of Iowa. He supports a local food bank, Loaves and Fishes, which serves 7 counties in the western suburbs of Chicago. Randy also has a love for music, fishing, sporting events and spending time with his wife, his two daughters and their husbands, his grandson, and his two granddogs—Alby the Beagle and Camp the Cockapoo.

AJA LEICHLITER

Sr. Director and Chief Compliance Officer

Ron Sullivan

With over eleven years experience in the healthcare industry, Aja is a noted, certified leader in compliance. Aja has applied her extensive knowledge of governing regulations—Affordable Care Act, HIPAA, HITECH, CMS—as well as the requirements of accrediting bodies—URAC, NCQA and HITRUST—to leadership positions within MRIOA and beyond. Having served in leadership capacities (President, VP, and Chair of the Legislative and Regulatory Committee) for the National Association of Independent Review Organizations (NAIRO), Aja is a trusted and demonstrated expert in the independent review industry.

In addition to her compliance acumen, Aja brings to her position a well-rounded perspective and diverse skill set. With a bachelor’s degree in business from the University of Utah, Aja has assisted initiatives across the organization, from client relations and case management to marketing. She has worked to integrate a compliance mindset into company-wide processes, which has resulted in a score of one hundred percent compliance upon desktop and onsite review over multiple accreditation cycles. When not geeking out on all things compliance, Aja is probably hiking, camping, playing volleyball, or watching her daughter’s impromptu daily performances.

BOB O’BRIEN

Executive, Best Care Business Unit

Ron Sullivan

Bob has more than 30 years of sales and marketing experience with numerous achievements in development of new markets and re-positioning of products and services in healthcare. Prior to joining MRIoA he held roles at CVS Aetna, Grand Rounds and ActualMeds.

Bob holds a bachelor’s degree from Assumption College and a Master’s in business administration from The University of Connecticut.

DAVID BAUGH, CPA

Chief Financial Officer

Ron Sullivan

Dave is a senior-level financial executive with over 27 years of experience in a wide variety of industries including over 17 years public accounting experience and 10 years serving as CFO, VP of Finance, controller and treasurer of private corporations. Dave was elected to be a partner in the leading locally-owned public accounting firm in Utah and has served companies in various industries including resort operations, manufacturing, software development, banking, retail, wholesale distributors, mining, medical products, technology, transportation, public utilities, financial institutions, natural resources, not-for-profit organizations, municipalities, school districts and employee benefit plans.

As the CFO of MRIoA, Dave is responsible for the administrative, financial and risk management operations of the company, including the development of a financial strategy, metrics tied to that strategy and the ongoing development and monitoring of control systems designed to preserve company assets and report accurate financial results.

Dave graduated Magna Cum Laude from Utah State University with a Master’s degree in accounting, an emphasis in accounting information systems and a minor in business administration. Dave is actively involved in the community and in various organizations. He has been a Rotarian, past president of the Northern Utah Chapter of the UACPA, has served on various UACPA committees, is a graduate of the Salt Lake Chamber’s Leadership Utah. He is a past board member of the Centerpoint Legacy Theatre and past Board Chair for Youthlinc, a non-profit organization dedicated to creating life-long humanitarians. Dave enjoys camping, backpacking, travel, making great BBQ, cooking and is a backyard beekeeper. Dave and his wife Linda have four children and live in Bountiful, UT.

Michelle Sterling, MD

Executive Medical Director – Clinical Quality

Sally Newton

Dr. Sterling joined MRIoA in January 2017 as a full time Associate Medical Director. She became a team lead in 2018 and subsequently was promoted to Director of Physician Client Relations. She works closely with Provider Relations to help oversee the external specialty physician panel. She also oversees the independent contractor team. She works closely with quality management and the customer success teams to develop and build-upon relationships with our clients and ensure quality reviews.

During her free time, Michelle enjoys spending time with her family including her husband and two daughters. She likes to travel, attend Penn State football games, bike and go to Disney World.

Dawn Maloney

Vice President of Marketing

Dawn Maloney

Dawn has strategic responsibility for developing and executing the marketing and sales engagement strategy for utilization and clinical review, 2nd opinions and data analytics. She is accountable for driving revenue from campaigns, executive client council and industry thought-leadership events and associations. Dawn has responsibility for positioning MRIoA as the industry leader of technology enabled provider of clinical insights to payers and patients through analytics and evidence-based clinical opinions derived from specialty reviews and virtual 2nd opinions that empower better decision-making. During free time you can find her visiting her daughters at college, golfing, playing pickle ball and volleyball.

Katie Tucker, PharmD

Director of Clinical Pharmacy – PA Pharmacists

Dawn Maloney

Katie joined MRIoA in 2017 as a Clinical Review Pharmacist and quickly moved up into a director role. Katie has been a pharmacist for over 10 years and in the pharmacy industry for over 15 years.  She loves working in the utilization management industry with clients to help advance patient outcomes with cost and best practices in mind.  Katie enjoys the outdoors of Colorado with her husband, son, and daughter.

JOIN THE MRIoA TEAM

MRIoA is a growing company that provides an exceptional, positive work environment, and team members can expect a career that is both challenging and rewarding. Every MRIoA employee is appreciated and valued for the skills, ideas and experience they bring to their position. We offer a generous compensation package including competitive wages and a comprehensive benefits package.

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White Papers
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Expert Medical Opinion with MyCareChoices™ – Your Telehealth 2nd Opinion

published white paper January 2023. Learn how providing patients with a 2nd opinion supports the appropriate treatment path up front.
White Papers
01/22/2023

The Future of Utilization Management

published white paper January 2023. Learn more about the transition from a traditional UM to a more innovative and technology-enabled solution.
Blog
12/30/2022

Optimize Prior Authorizations to Unlock A 7:1 ROI

Increasing prior authorization efficiency helps patients, providers, and health plans collaborate effectively: decreasing overutilization while increasing proper patient care. Through MRIoA’s PA Optimization Platform™, health plans can save hundreds of thousands…