Clinical Leadership Specialist

3 weeks ago


Downingtown, Pennsylvania, United States Community Behavioral Health Full time
Job Title: Physician Advisor

Community Behavioral Health is seeking a highly skilled Physician Advisor to provide clinical leadership and oversight of the clinical management of members. The ideal candidate will have a medical degree (MD or DO) and significant experience in clinical psychiatry, including inpatient care and substance abuse treatment.

Key Responsibilities:
  • Perform physician reviews in alignment with best practice standards (NCQA) and state regulatory requirements to improve outcomes for CBH members.
  • Engage, collaborate, and troubleshoot with providers and system stakeholders on clinical and medical matters, including member placement, coordination of care, quality concerns, and other challenges.
  • Participate in quality reviews as needed for specific member complaints, grievances, and agency reviews.
  • Participate in clinical and administrative meetings as a representative of medical affairs and clinical as required.
  • Participate in training and education with internal and external stakeholders, including care managers, providers, and others as required.
  • Review cases from multiple sites and levels of care for medical necessity.
  • Perform peer review cases for disputed levels of care.
  • Interact with providers on clinical and administrative matters.
  • Serve as a consultant for Clinical Care Managers.
Requirements:
  • Medical degree (MD or DO)
  • PA Licensure; Board Certified in Adult or Child Psychiatry
  • Minimum of 2 years of clinical psychiatry experience, including significant and specific experience with inpatient care and substance abuse treatment
Work Environment:

The Physician Advisor will work in a fast-paced environment, requiring strong problem-solving and analytical skills, as well as excellent verbal and written communication skills. The ability to travel within the City of Philadelphia is required.

CBH is an equal opportunity employer and does not discriminate in recruiting, hiring, promotion, or any other personnel action based on all qualified individuals. We strive to promote and sustain a culture of diversity, inclusion, and belonging every day.



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