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How much do sharp health plan jobs pay per hour?

As of May 28, 2026, the average hourly pay for sharp health plan in the United States is $41.17, according to ZipRecruiter salary data. Most workers in this role earn between $19.95 and $58.41 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Health Plan Administrator, and why are they important?

To thrive as a Health Plan Administrator, you need a solid understanding of healthcare regulations, insurance practices, benefits administration, and often a bachelor's degree in healthcare administration or a related field. Familiarity with insurance claims processing systems, HIPAA compliance tools, and data analysis software is typically required. Strong problem-solving, communication, and organizational skills help you effectively manage member services and coordinate with providers. These competencies are crucial for ensuring regulatory compliance, optimizing plan operations, and maintaining high member satisfaction.

What are some typical challenges faced by professionals working at Sharp Health Plan, and how can new employees navigate them successfully?

Professionals at Sharp Health Plan often encounter challenges related to adapting to evolving healthcare regulations, maintaining high standards for member service, and collaborating across multidisciplinary teams. New employees can navigate these challenges successfully by staying updated on industry best practices, actively participating in ongoing training, and communicating openly with colleagues. Embracing the company’s collaborative culture and leveraging available resources for professional development will also help new team members thrive in their roles.

What is Sharp Health Plan?

Sharp Health Plan is a health insurance provider based in San Diego, California. It offers a variety of health insurance plans for individuals, families, and employers, focusing on delivering quality care and excellent customer service. As part of the Sharp HealthCare system, Sharp Health Plan members have access to a large network of doctors, specialists, and hospitals in the region. The organization is known for its competitive rates, personalized support, and commitment to community wellness.

What is the difference between Sharp Health Plan vs Health Insurance Agent?

AspectSharp Health PlanHealth Insurance Agent
CredentialsLicensed health insurance plans, certifications in health insuranceLicensed insurance agent, certifications vary by state
Work EnvironmentHealthcare provider organization, insurance plan administrationIndependent or agency-based, sales and client consultation
Employer & Industry UsageHealth insurance provider, healthcare industryInsurance companies, brokerages, healthcare agencies
Primary FocusProviding health insurance plans to membersSelling insurance policies, advising clients

Sharp Health Plan primarily offers health insurance coverage directly to members, focusing on plan administration and healthcare services. In contrast, a health insurance agent acts as a sales intermediary, helping clients select suitable plans and guiding them through enrollment. While both roles require licensing and knowledge of health insurance products, Sharp Health Plan is a provider organization, whereas agents work independently or for brokerages to facilitate insurance sales.

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What states have the most Sharp Health Plan jobs? States with the most job openings for Sharp Health Plan jobs include:
What job categories do people searching Sharp Health Plan jobs look for? The top searched job categories for Sharp Health Plan jobs are:
Sharp Health Plan jobs near you
Credentialing Data Analyst - SHP Health Services - Telecommuter - Day Shift - Full Time

Credentialing Data Analyst - SHP Health Services - Telecommuter - Day Shift - Full Time

Sharp HealthCare

San Diego, CA • On-site

$32.73 - $40.91/hr

Full-time

Posted 12 days ago

Sharp HealthCare rating

8.7

Company rating: 8.7 out of 10

Based on 99 frontline employees who took The Breakroom Quiz

6th of 864 rated healthcare providers

Job description

Hours:
Shift Start Time:
8 AM
Shift End Time:
5 PM
AWS Hours Requirement:
8/40 - 8 Hour Shift
Additional Shift Information:
Weekend Requirements:
No Weekends
On-Call Required:
No
Hourly Pay Range (Minimum - Midpoint - Maximum):
$32.730 - $40.910 - $45.810
The stated pay scale reflects the range that Sharp reasonably expects to pay for this position. The actual pay rate and pay grade for this position will be dependent on a variety of factors, including an applicant's years of experience, unique skills and abilities, education, alignment with similar internal candidates, marketplace factors, other requirements for the position, and employer business practices.
What You Will Do
Under the direction of the Network Management and Application Optimization, Manager, this position performs and coordinates credentialing delegation functions for Sharp Health Plan in order to maintain a quality provider network. Serves as a liaison to delegated entities, the Credentialing Verification Office (CVO), vendors and internal Sharp Health Plan teams to ensure current and adequate credentialing processes are in place. Responsible for the maintenance of the provider database to ensure data integrity, including data accuracy, completeness, and consistency (standardization). Develops and performs database queries and abstracts for provider rosters, directories and statistical reporting on a frequent basis.
Required Qualifications
  • Bachelor's degree healthcare management, business
  • 2 years' database management.
  • 3 years' experience in managed care field.

Preferred Qualifications
  • 1 year experience in cloud-based credentialing database applications such as MD-Staff or other similar solutions.
  • Certified Provider Credentialing Specialist (CPCS) - National Association Medical Staff Services -PREFERRED

Other Qualification Requirements
  • Other degree acceptable with a combination of education, managed care, and supervisorial experience.

Essential Functions
  • Credentialing delegation oversight
    Knowledge of Department of Managed Care (DMHC), Knox Keene Act for regulations governing Health Maintenance Organizations (HMOs) and Department of Health Services (DHS) regulations regarding delegated services.
    Maintains current knowledge of delegation, contractual agreement(s), and reimbursement models.
    Maintains current knowledge of National Committee for Quality Assurance (NCQA), Department of Managed Health Care (DMHC), Industry Collaboration Effort (ICE), and Centers for Medicare and Medicaid Services (CMS) regulatory standards to ensure Sharp Health Plan credentialing processes meet all health plan contractual compliance requirements. Provides reporting, feedback and documentation, as necessary, to maintain compliance with delegated credentialing requirements.
    Works closely with the Credentialing Verification Organization (CVO) to manage deliverables as defined in the Sharp Health Plan / CVO delegation agreement.
    Responsible for review and ongoing monitoring of credentialing materials to ensure accurate and timely credentialing and re-credentialing of SHP providers within required regulatory timeframes.
    Responsible for plan medical group, group practice, and service ancillary credentialing delegation oversight activities through review of documents and preparation of reports applicable to the oversight process, and coordination with the CVO.
    Responsible for Health Delivery Organizations (HDO) facility credentialing delegation oversight to ensure adherence to NCQA and CMS standards.
    Conducts recredentialing review to include quality indicators such as member appeals, grievances and potential quality issues, working in collaboration with internal teams.
    Performs credentialing audits of delegated entities that perform credentialing functions according to their Sharp Health Plan delegation agreements to ensure compliance with Sharp Health Plan, NCQA, DMHC, CMS and other federal and state credentialing standards.
    Monitors compliance with corrective action plans. Works with accountable leaders to assure all action items are complete within required deadlines.
    Collaborates with the Medical Management and Network Management to obtain complete results of provider site audits.
    Prepares Peer Review Committee information summaries and presents relevant material at quarterly Peer Review Committee meetings.
    Prepares credentialing summaries for all practitioners meeting the Sharp Health Plan threshold criteria for "clean file" and "unclean file" review for presentation at monthly Peer Review Committee meetings.
    Responsible for maintaining timely, complete, accurate credentialing documentation in electronic format.
    Prepares accreditation information for submission and coordinates surveys for organization.
    Provides consultation on the development of guidelines, policies, procedures and protocols.
    Establishes and maintains processes to conduct annual review of delegate credentialing policies and procedures. Reviews for completeness and accuracy as it relates to regulatory standards.
    Develops and maintains policies and procedures for all credentialing and peer review processes in accordance with Sharp Health Plan, NCQA, DMHC, CMS, and other federal and state requirements.
    Participates in ICE workgroups related to credentialing activities to maintain policies and procedures in compliance with regulatory agencies.
    Attends internal and external meetings as appropriate.
  • Customer service
    Establishes good working relationships with providers, CVO contacts, medical directors, and all levels of internal and external customers.
    Demonstrates ability to be flexible and prioritize to meet the needs of the organization.
    Prepares clearly written and professional work products.
    Demonstrates cooperation and teamwork and assists others as needed. Accepts interpersonal differences and promotes cooperation with colleagues.
    Fosters open lines of communication and informs leadership of any issues relating to compliance or organizational risk.
    Coordinates and completes assigned projects as required.
    Performs other duties as assigned by the Network Management and Application Optimization, Manager.
  • Database management
    Familiarity with basic principles of relational database management and elements of a database.
    Builds database queries and sets up job scheduling.
    Ensures the maintenance of the provider database and is responsible for reporting accurate information for required reports and provider directories.
    Experience developing and identifying processes by which reports are compiled using relational databases.
    Responsible for maintaining data integrity by systematically auditing database entries.
    Develops and maintains timely database policies and procedures.
    Identifies and takes action on IT upgrades to achieve database efficiencies, ease the burden of manual processes and implement department process improvements to maximize efficiency, effectiveness, and productivity in daily work activities.
    Analyzes database administration inefficiencies and streamlines processes accordingly.
  • Statistical Reporting
    Produces and reviews statistical reports to monitor delegation oversight and network activities.
    Prepares complex charts and graphs to summarize and visualize report data on an as-needed basis.
    Responsible for validating the accuracy of statistical reporting, e.g., regulatory filings, dashboards, et al, based on database queries and abstracts.
    Tracks and trends identified reports to monitor network activity.
    Ensures accuracy of provider data extracts used for provider directories through data validation procedures.
    Ensures accuracy of management and regulatory reports.
    Compiles statistical reports, on a frequent basis, to demonstrate productivity and efficient workflow processes.
  • Process improvement
    Utilizes a continuous quality improvement approach to identify and initiate department process improvements to maximize efficiency, effectiveness, and productivity in daily work activities.
    Makes recommendations to the Network Management and Application Optimization Manager on process improvements with the goal of enhancing quality and provider/member satisfaction.

Knowledge, Skills, and Abilities
  • Excellent verbal and written communication skills.
  • Excellent organizational skills with attention to detail.
  • Strong analytical skills to evaluate, interpret and communicate data in a clear, concise manner.
  • Excellent interpersonal skills.
  • Ability to tactfully interact with the CVO, providers and their staff.
  • Ability to define and prioritize tasks, manage workload and meet deadlines with minimal supervision.
  • Thorough understanding of managed care principle, evolutions, and models.
  • Familiarity with Department of Managed Health Care (DMHC) and DHS audit requirements as well as NCQA standards for delegation.
  • Demonstrates courteous, professional, and cooperative behavior toward internal and external customers.
  • Knowledge of NCQA, DMHC and CMS credentialing standards, legislative and regulatory requirements.
  • Excellent computer skills, including proficiency in the MS Office Suite, including MS Excel, MS Word, MS PowerPoint, MS Access.
  • Expert knowledge in cloud-based applications such as MS Teams, SharePoint, Smartsheet, etc.
  • Ability to maintain peer review information confidentiality consistent with California Evidence Code 1157 for credentialing and peer review activities.

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 or any other protected class

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About Sharp HealthCare

Sourced by ZipRecruiter

Sharp HealthCare is a leading healthcare organization based in San Diego, CA, in the US. Founded in 1955, it serves as a critical part of the California healthcare industry, providing a wide range of medical services. The company owns and operates several hospitals, medical groups, and health plans, offering comprehensive healthcare solutions to the residents of San Diego County. The organization's mission is to improve the health of those it serves with a commitment to excellence in all that it does. This commitment is driven by its core values, dubbed "The Sharp Experience," which emphasizes understanding, empathy, and respect towards every individual.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

San Diego, CA, US

Year founded

1955

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