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Physician Reviewer

San Diego, CA
We’re working on behalf of a highly respected healthcare system whose health plan is the largest, locally-based commercial health plan in San Diego. A not-for-profit organization serving the needs of San Diegans since 1992, they are a subsidiary of San Diego’s largest provider of health care services, connecting their members to an award-winning network of hospitals, medical groups and physicians. They offer health insurance options for individuals, families, groups and businesses that combine affordability, choice, high-quality health care and personal service.

We seek candidates with Board Certification in Internal Medicine or Family Medicine for the role of Physician Reviewer. The person in this role 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.

Candidates must have an M.D. degree and be licensed to practice in California (or be in progress prior to start date). Must have five (5) or more years of experience as a practicing primary care physician with knowledge of managed care and the process for prior authorization review. Must have strong knowledge of physician social and political behavior and managed care philosophy. Must have effective communication skills and be able to work collaboratively with medical leadership and administration of the health plan, medical staff, nurses, and hospital administration.

The role offers highly competitive compensation and benefits. Relocation assistance is available. This is a great opportunity to join a healthcare organization that is highly focused on its mission to offer quality care and services that set community standards and exceed patients’ expectations that are provided in a caring, convenient, cost-effective and accessible manner. For more information call 941.739.1400 or submit your resume now by clicking on the button below that says “Apply Now.”

Eric Boelkins
Edge Recruitment Solutions
888.666.2450 or 941.739.1400
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