PHYSICIAN LICENSURE IN ALL 50 STATES
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.
“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.
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.
MRIoA’S EXECUTIVE TEAM
Chief Executive Officer
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
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
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. CRAIG HERSH
Chief Medical Officer
Dr. Craig Hersh joined Medical Review Institute of America in June 2021 as the Chief Medical Officer. He is accountable for the clinical aspects of the organization. Prior to joining MRIoA, Dr. Hersh was the Senior Clinical Officer and Regional Vice President for Anthem Northeast, as well as Chief Medical Officer for Empire BCBS.
Chief Revenue Officer
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.
Sr. Director and Chief Compliance Officer
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.
Executive, Best Care Business Unit
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
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.
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.