Medical Director for Adult Services
Company: Community Behavioral Health.
Location: Philadelphia
Posted on: October 29, 2024
Job Description:
The Medical Director of Adult Services is responsible for
providing administrative oversight and supervision of the CBH
physician advisors conducting utilization review for our adult
members. The position provides leadership in the development and
implementation of clinical/medical policies and initiatives as well
as engagement of cross-systems stakeholders for adult services. The
Medical Director may also conduct utilization reviews and will
participate in the physician's after-hours call coverage.The
Medical Director of Adult Services must be committed to fostering a
supportive and collaborative environment, encouraging teamwork and
mentorship at every level. This requires exemplary communication
skills with both internal and external stakeholders. He/she must
support the mission, vision, and values of CBH and DBHIDS.Core
Expectations: Community Behavioral Health (CBH) will hold each
employee accountable for the following expectations which align
with our mission, vision, and corporate code of conduct.
- Perform key responsibilities as detailed in this job
description in a dependable, responsible, and positive manner,
consistent with all state and federal guidelines.
- Serve as a role model by exemplifying the highest standards of
professional behavior, language, skills, and experience in order to
promptly, accurately, and compassionately serve the needs of
stakeholders, members and their families.
- Assure adherence to CBH policies and procedures so that all
work is of the highest quality and delivered in the most culturally
competent and cost-effective manner.
- Promote and manage diversity and acceptance within CBH and with
all members and stakeholders by honoring and respecting
individuality, cultural differences, dignity, and rights.
- Offer suggestions and develop solutions to help promote
effective and efficient work processes and innovative
programs.
- Actively participate in required meetings and complete all
mandatory training.
- Maintain high levels of advocacy and member confidentiality to
ensure the success of CBH and its mission.
- Assist in assuring both internal and external program integrity
by being alert to and reporting suspected instances of provider and
employee fraud, waste or abuse.
- Champion member safety and well-being as the top priority in
day-to-day operations.Essential Functions:
- Builds and maintains a strong functional team through effective
recruiting, training, performance management, coaching, team
building and succession planning.
- Provides supervision, guidance and leadership of adult
physician advisors regarding clinical review of cases for medical
necessity and care management
- Establishes and monitors performance expectations for adult
physician advisors
- Monitors physicians' productivity and effectiveness in
conducting peer utilization review
- Ensures physician review processes and content are aligned with
best practice standards (NCQA) and state regulatory
requirements
- Coordinates physician schedules to ensure adequate coverage
(including nights/weekends/holidays) of clinical services
- Partners with leadership team to ensure optimal care management
and medical review functioning leading to improved outcomes for CBH
members
- Provides medical leadership related to overall quality of care,
medical decision making, case formulations, appropriate use of
medication and other treatment modalities while addressing safety
concerns specific to case review and levels of care
- Engages, collaborates and troubleshoots with providers and
system stakeholders on clinical and administrative matters,
including member placement, coordination of care, quality concerns
and other challenges
- Participates in quality reviews as needed for specific member
complaints, grievances, and agency reviews
- Participates in clinical and administrative meetings as
required
- Participates in training and education with both internal and
external stakeholders, including care managers, providers and
others as required.
- Demonstrates deep personal commitment to the Mission, Vision,
and work of the CBH and DBHIDS
- Maintains expertise/education/training regarding most
up-to-date standards of care
- Possesses leadership and medical experience necessary to
effectively take on the tasks inherent in this role. Position
Requirements:
- Education: Medical degree
- License/Certification: State license in the Commonwealth of
Pennsylvania; Board Certification in Adult Psychiatry
- Relevant Work Experience: Minimum of 3 years of experience in
clinical psychiatry, preferably including inpatient exposureSkills:
- Problem solving and strong analytical skills
- Excellent interpersonal skills
- Flexibility in assessing situations and evaluating needs
- Proficient in Microsoft Word and Excel
- Strong administrative and managerial skills
- Excellent verbal and communication skills Leadership
Competencies:
- Strategic Thinking: Understand and integrate the long-term
vision of CBH and focus current activities on what is critical to
achieve future success including formulating objectives/priorities
and developing and implementing breakthrough ideas.
- Leadership: Effectively manage and guide efforts to address
challenges and drive continuous improvement for CBH's programs,
services and processes. Develop and implement effective strategies
and tailor appropriate interpersonal styles to influence and guide
others.
- Employee Development: Recognize and promote the necessity to
hire, assess, develop and retain high quality talent. Acknowledge
strengths and weaknesses in team members through an ongoing
performance management process that provides timely feedback in
order to aid employee development and enhance team performance.
Work Conditions (including travel, overtime required, physical
requirements and occupational exposure):
- Must be able to travel within the City of Philadelphia.
- Regularly requires walking, standing, stooping, bending,
sitting, reaching, pushing, pulling and/or repetitive wrist/hand
movements for various lengths of time throughout the day.
- Ability to utilize computers and office equipment to complete
daily work responsibilities.
- Regularly works inside in areas that are adequately lighted and
ventilated. Some fluctuation in temperature. No protective
equipment routinely needed.
- Must be able to adapt to continuous changes/demands of the
job.U.S. Authorization Requirement:
- CBH does not provide sponsorship for applicants requiring
future work authorization. All candidates must be legally
authorized to work in the United States without requiring
sponsorship now or in the future.Equal Employment Opportunity:
- We strive to promote and sustain a culture of diversity,
inclusion and belonging every day. CBH is an equal opportunity
employer. We do not discriminate in recruiting, hiring, promotion,
or any other personnel action based on all qualified individuals.
This is without regard to race, ethnicity, creed, color, religion,
national origin, age, sex/gender, marital status, gender identity,
sexual orientation, gender identity or expression, disability,
protected veteran status, genetic information or any other
characteristic protected individual genetic information, or
non-disqualifying physical or mental handicap or disability in each
aspect of the human resources function by applicable federal,
state, or local law.Requesting An Accommodation:
- CBH is committed to providing equal employment opportunities
for individuals with disabilities or religious observance,
including reasonable accommodation when needed. If you are hired by
CBH and require an accommodation to perform the essential functions
of your role, you will be asked to participate in our accommodation
process. Accommodations made to facilitate the recruiting process
are not a guarantee of future or continued accommodation once
hired.
- If you would like to be considered for employment opportunities
with CBH and have accommodation needs for a disability or religious
observance, please send us an email at
PIb59b88cad806-31181-34529607
Keywords: Community Behavioral Health., Hackensack , Medical Director for Adult Services, Healthcare , Philadelphia, New Jersey
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