Physician Advisor

About the Role

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.

Responsibilities

• Provide clinical leadership through oversight of the clinical management of members.
• Provide 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.
• 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.
• Participate in clinical and administrative meetings as 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.
• Complete other duties as assigned.

Core Expectations

• 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.