Sr. 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 Sr. 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 Sr. 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 Sr. 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 Sr. 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