Utilization Review Physician - New Jersey (Mostly Remote)

Job Description

Job Description

Vivo HealthStaff is recruiting for a Utilization Review Physician based in New Jersey for a Managed Care Insurance Plan. This position requires 4 days per month on-site.

The Utilization Review Physician is the lead clinician for the health plan. Responsible for the administration of medical services for company health plan utilizing the evidence-based medical policies and clinical guidelines of the plan, to ensure the appropriate and most cost-effective medical care is accessible and delivered to our members. Drives direction of the plan related to cost of care, clinical initiatives and population health management and outcomes.

Will function as the clinical lead, working alongside state plan president as the team interfaces with state regulators, providers and market facilities.

Requirements :

• Board Certification in a specialty certified by either the American Board of Medical Specialties or American Osteopathic Association
• Unrestricted Medical License in the State of New Jersey
• Minimum of 10 years of clinical practice post residency