Utilization Review Physician Mostly Remote at Vivo HealthStaff Carteret, NJ

Utilization Review Physician - New York (Mostly Remote)

Vivo Health Staff is recruiting for a Utilization Review Physician based in New York for a Managed Care Insurance Plan. This position requires 4 days per month onsite.

Responsibilities:

• The Utilization Review Physician is the lead clinician for the health plan, responsible for the administration of medical services for the company health plan using evidence‑based medical policies and clinical guidelines to ensure the appropriate and 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.
• Functions as the clinical lead, working alongside the 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 York
• Minimum of 10 years of clinical practice post‑residency

Remote working/work at home options are available for this role.