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Family Medicine Physician for Utilization Review - San Diego, Californ

Company: Integrity Healthcare
Location: San Diego
Posted on: January 15, 2021

Job Description:

Looking for someone who has experience with weekly chart review and human resource evaluations and assessing untoward outcomes of medical decisions specifically for Medical groups/Healthplans. Looking at someone that could potentially transition to CMO/VP position in the next 3-5 years 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.

  • 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. 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. Required Skills and Qualifications
  • M.D. Degree
  • License to practice in California must be in hand or in progress
  • 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, medical staff, nurses, and hospital administration.
  • Board Certification in Internal Medicine or Family Medicine Hours 8-hour shift: 8:00 am - 5:00 pm, weekends as needed. Keyphrases: family medicine jobs, family practice jobs, family practitioner jobs, family medicine specialist jobs

Keywords: Integrity Healthcare, San Diego , Family Medicine Physician for Utilization Review - San Diego, Californ, Healthcare , San Diego, California

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