Physician Advisor

Community Behavioral Health; Philadelphia (Philadelphia County); On-site; USD 180,000 - 240,000; Full time

Benefits offered by this job

Family Planning, Fertility, Adoption

403B Retirement Plan

PTO Days/Sick Days

Wellness Program

Employee Assistance Program

Medical, Prescription Drug Insurance

Tuition Reimbursement

Flexible Spending

Job summary

Community Behavioral Health (CBH) in Philadelphia seeks a Physician Advisor to provide clinical leadership through oversight of member care and medical decision making.

The role emphasizes quality reviews, coordination with care managers, and consultation on cases, levels of care, and safety concerns, with a focus on inpatient settings and substance abuse treatment.

Qualifications

• Medical degree as a Psychiatrist (MD or DO).
• PA licensure and board certification in psychiatry as specified.
• Minimum 1 year of clinical psychiatry with inpatient and substance abuse experience.

Responsibilities

• Provide clinical leadership through oversight of clinical management for CBH members.
• Consult on medical decision making, case formulations, and safety concerns.
• Engage with providers and stakeholders on clinical matters and care coordination.
• Participate in quality reviews, trainings, and clinical/administrative meetings.
• Review cases for medical necessity across sites and levels of care.
• Act as consultant for Care Managers and support program integrity.

Skills

Problem solving

Analytical skills

Interpersonal skills

Verbal and written communication

Education

MD or DO Psychiatry

PA Licensure

Board Certified in Adult or Child Psychiatry

Tools

Microsoft Word

Excel

Job description

CBH is a dynamic organization dedicated to providing access to high-quality, accountable care to improve the health and mental wellness of our members. As part of our growth, we are seeking a detail-oriented Physician Advisor to join our team.

CBH offers a robust compensation and benefits package, including:

• Family Planning, Fertility, Adoption Benefits
• 403B Retirement Plan
• PTO Days/Sick Days
• Wellness Program
• Employee Assistance Program
• Medical, Prescription Drug Insurance
• Tuition Reimbursement
• Flexible Spending

The Physician Advisor is responsible for providing clinical leadership through oversight of the clinical management of members. The Physician Advisor provides consultation regarding overall quality of care, medical decision making, case formulations, medication and other safety concerns, specific to case review and levels of care or cohort.

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 professional behavior, language, skills, and attire in order to promptly and accurately 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 their individuality, 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 trainings.
• Maintain high levels of advocacy and member confidentiality to ensure the success of CBH and our 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.

Essential Functions

• Performs physician reviews in alignment with best practice standards (NCQA) and state regulatory requirements and with the goal of improved outcomes for CBH members.
• Engages, collaborates and troubleshoots with providers and system stakeholders on clinical and medical 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 representative of medical affairs and clinical as required.
• Participates in training and education with both internal and external stakeholders, including care managers, providers and others as required.
• Reviews cases from multiple sites and levels of care for medical necessity.
• Performs peer review cases for disputed levels of care.
• Interact with providers on clinical and administrative matters.
• Serve as a consultant for Clinical Care Managers.
• Completes other duties as assigned.

Position Requirements

• Education: Medical degree as a Psychiatrist (MD or DO)
• License/Certification: PA Licensure; Board Certified in Adult or Child Psychiatry (Adult specialty preferred)
• Relevant Work Experience: Minimum of 1 year of clinical psychiatry experience including significant and specific experience with inpatient care and substance abuse treatment

Skills

• Proficient in Microsoft Word and Excel
• Problem solving and analytical skills
• Strong interpersonal skills
• Excellent verbal and written communication skills

Core Competencies

Teamwork and Collaboration: Build and sustain relationships with co-workers and stakeholders and support efforts and deliverables. Encourage unity and help remove barriers to productivity and success.

Respect: Treat each other and our members and stakeholders with respect and sensitivity, recognizing the importance of diversity.

Member Centric: Focus on the needs of our members by providing value-added services, promoting strong relationships and going beyond basic expectations to achieve the best possible outcomes.

Honesty and Integrity: Be open and honest in all we do. Maintain the highest level of integrity at all times.

Commitment to Service Excellence: Challenge ourselves to be forward-thinking and committed to providing total member and stakeholder satisfaction, first-in-class service and high quality, innovative programs.

Compassion and Empathy: Demonstrate a deep appreciation for another’s situation and point of view. Pay attention to emotional cues, listen effectively and show an exceptional level of caring about each person’s perspectives and circumstances.

Problem Solving: Build and implement logical solutions to resolving challenges/issues by using individual knowledge and experience while taking resources, constraints and CBH values into consideration.

Initiative and Self-Directed: Proactively manage time and resources in a way that ensures that all work is done in the most efficient manner while identifying and implementing initiatives without interventions from co-workers, supervisors or stakeholders.

Flexibility and Adaptability: Adjust approaches and behaviors in order to meet the constantly changing environment head-on and accomplish CBH and individual goals. Strive to adapt to, accept and embrace change within areas of responsibility.

Communication: Effectively and appropriately share thoughts, ideas and information - both written and oral. Respectfully listen to co-workers and stakeholders to gain a full understanding of issues/situations.

Work Conditions

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.
• 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 [e-mail]