Location

This position is located in Kearny Mesa, San Diego County

Hours

8-hour shift: 8:00 am – 5:00 pm, weekends as needed.

Required Skills and Qualifications

• M.D. Degree
• License to practice in California must be in progress prior to start date
• Five years experience as a practicing primary care physician with knowledge of managed care and the process for prior authorization review
• Knowledge of physician social and political behavior and managed care philosophy
• Effective communication skills
• Ability to work collaboratively with medical leadership and administration of Sharp Health Plan, medical staff, nurses, and Sharp hospital administration.

Preferred Skills and Qualifications

• Board Certification in Internal Medicine or Family Medicine

Sharp HealthCare is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender, gender identity, sexual orientation, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

Summary

The Physician Reviewer will perform all reasonably necessary functions to ensure quality of care and appropriate utilization in the most cost-effective, appropriate and professional manner, which meets the expressed needs of patients and professional colleagues. 

The Physician Reviewer will be a part of the Health Services Department. This department is comprised of areas of Medical Management, Provider Relations/Network Support, Quality Improvement and Pharmacy. 

If you like the sound of what it means to be a Sharp Health Plan team member, and you meet the qualifications above, please submit your resume along with a brief explanation about why you would be a good fit for this position. We look forward to hearing from you!

Sharp Health Plan is the largest, locally-based commercial health plan in San Diego. We are a not-for-profit organization serving the needs of San Diegans since 1992. As a subsidiary of Sharp HealthCare, San Diego’s largest provider of health care services, we not only serve the people of San Diego, we are the people of San Diego.

Through our unique integration with Sharp HealthCare, we connect our members to an award-winning network of hospitals, medical groups and physicians. We offer health insurance options for individuals, families, groups and businesses that combine affordability, choice, high-quality health care and personal service.

Security Clearance Required: No

Visa Candidate Considered: No

Compensation

Base Salary - $157,410 to $248,809

Full-time

Benefits - Full

Relocation Assistance Available - Possible for ideal candidate

Candidate Details

7+ to 10 years experience

Seniority Level - Mid-Senior

Management Experience Required - No

Minimum Education - Doctorate Degree

Willingness to Travel - Occasionally