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    Medical Director - Philadelphia, United States - Community Behavioral Health

    Community Behavioral Health
    Community Behavioral Health Philadelphia, United States

    2 weeks ago

    Default job background
    Full time
    Description

    Medical Director of Quality Management Position at Community Behavioral Health (CBH)

    The Medical Director of Quality Management plays a crucial role in providing medical leadership to the Quality Management department at CBH, focusing on continuous quality improvement within the provider network. This individual also supervises Physician Advisors who conduct quality reviews.

    Core Expectations:

    • Perform responsibilities outlined in the job description in a dependable and positive manner in compliance with state and federal guidelines.
    • Lead by example with professional behavior, language, and attire to meet the needs of stakeholders, members, and families promptly and accurately.
    • Ensure adherence to CBH policies for delivering high-quality and culturally competent work.
    • Promote diversity and acceptance within CBH and among stakeholders by respecting individuality and rights.
    • Offer suggestions to enhance work processes and programs effectively.
    • Participate in meetings and training sessions.
    • Maintain member confidentiality and advocate for the mission of CBH.
    • Alert and report any suspected cases of fraud, waste, or abuse.

    Essential Functions:

    • Conduct oversight and evaluation of physician advisors. Review performance related to quality activities.
    • Develop quality standards and clinical guidelines aligned with network priorities.
    • Provide feedback to network providers on quality of care and assist in Quality Improvement Plan oversight.
    • Implement and evaluate program assessments for quality care.
    • Monitor and establish quality metrics and activities for trend identification and goal achievement.
    • Review and present Quality Management reports to stakeholders.
    • Lead the Quality Improvement Committee.
    • Drive NCQA accreditation efforts for the health plan.
    • Participate in Quality and medical leadership meetings.

    Position Requirements:

    • Education: MD or DO from accredited medical school; completion of psychiatry residency program.
    • License/Certification: Board certification in psychiatry and PA Medical License required.
    • Certified Professional in Healthcare Quality preferred.
    • Work Experience: Minimum 3 years post-residency; quality management experience preferred.

    Skills:

    • Collaborative work ability.
    • Strong verbal and written communication skills.
    • Mediation skills.
    • Independent work capability in a fast-paced environment.
    • HIPAA compliance.

    Work Conditions:

    • Field and office work within Philadelphia and surrounding areas.
    • Physical requirements including standing, sitting, and computer use.
    • Adaptability to job demands and changes.

    U.S. Authorization Requirement:

    • No sponsorship provided for future work authorization.

    Equal Employment Opportunity:

    • Promotion of diversity and inclusion at CBH, an equal opportunity employer.

    Requesting An Accommodation:

    • CBH ensures equal employment opportunities for individuals with disabilities or religious observance.
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