Physician Advisor (Psychiatrist)

Job Description

Job Description

Position Overview :

The Physician Advisor provides strategic oversight of medical necessity determinations for behavioral health services, ensuring alignment with clinical standards and organizational objectives. This role is accountable for conducting medical necessity and peer reviews, directing the activities of the crisis team, and fostering collaboration with clinical providers to promote high-quality, effective mental health care for CBH Members.

Essential Functions :

• Review cases from multiple sites and levels of care for medical necessity.
• Peer review cases for disputed levels of care.
• Perform medical reviews
• Make denial decisions based on medical necessity
• Participate in clinical and administrative meetings.
• Interact with providers on clinical and administrative matters.
• Serve as clinical leadership resource and consultant to Clinical Care Managers, offering guidance on complex cases and best practices.

Position Requirements :

Education :

License / Certification :

Relevant Work Experience :

Skills :

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.

Core Competencies :

Leadership Competencies :

CBH Requirements and Accommodations :

Philadelphia Residency Requirement :

U.S. Authorization Requirement :

Equal Employment Opportunity :

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 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 accommodation to perform the essential functions of your role, you will be asked to participate in our accommodation process. Accommodation made to facilitate the recruiting process is 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 CBH.Recruitment@Phila.gov