Utilization Review Physician — New Jersey (Mostly Remote)

Job overview

The Utilization Review Physician role is mostly remote in New Jersey, with four days per month onsite. Compensation is not specified. The physician serves as clinical lead for a managed care health plan and supports evidence-based, cost-effective care for members.

What you'll do

• Administer medical services for the health plan using its evidence-based medical policies and clinical guidelines
• help direct cost-of-care, clinical initiatives, and population health outcomes
• and work with the state plan president as the team interfaces with state regulators, providers, and market facilities.

What we're looking for

Skills & competencies

utilization review physician

new jersey

mostly remote

four days per month onsite

managed care

clinical leadership

medical policies

clinical guidelines

population health

board certification

new jersey medical license

Work arrangement

• Weekend coverage required

Why this role

The role combines clinical leadership with health-plan medical policy and population health responsibilities.

About the employer

Vivo HealthStaff is hiring for this role. Industry: Direct Health and Medical Insurance Carriers. Sector: 52.