Physician Review/Utilization Review Physician

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Job Description

Last updated: 4/18/25

Vivo HealthStaff is searching for a Physician for a health plan based in San Diego, CA. This is a full-time position with competitive benefits.

The Physician Reviewer will perform all reasonably necessary functions to ensure the 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.

POSITION REQUIREMENTS:
  • M.D. Degree
  • License to practice in California must be in progress prior to the 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
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