Medical Director for Clinical Affairs

6 days ago


Philadelphia, Pennsylvania, United States Community Behavioral Health. Full time

We are seeking a highly qualified Physician Advisor to join our team at Community Behavioral Health. This is a part-time position with 15 hours per week, working two 7.5-hour days.

Job Overview

This role provides clinical leadership and oversight of the clinical management of members. The Physician Advisor will provide consultation on overall quality of care, medical decision making, case formulations, medication and other safety concerns, specific to case review and levels of care or cohort.

Key Responsibilities
  • Perform physician reviews in alignment with best practice standards (NCQA) and state regulatory requirements with the goal of improved 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.
  • Attend clinical and administrative meetings as representative of medical affairs and clinical as required.
  • Participate in training and education with both 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.
  • Act as a consultant for Clinical Care Managers.
Requirements
  • Education: Medical degree (MD or DO)
  • License/Certification: PA Licensure; Board Certified in Adult or Child Psychiatry
  • Relevant Work Experience: Minimum of 2 years of clinical psychiatry experience including significant and specific experience with inpatient care and substance abuse treatment
Skills and Qualifications
  • Proficient in Microsoft Word and Excel
  • Problem solving and analytical skills
  • Strong interpersonal skills
  • Strong decision making skills
  • Excellent verbal and written communication skills
Estimated Salary:

$120,000 - $150,000 per year based on location and experience.

Please note that this is an estimate and may vary based on individual circumstances.


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