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Title

Chief Medical Officer 

Category Medical Management  
Req Number MED-18-00003  
Description

Alliance Behavioral Healthcare is seeking a Chief Medical Officer to provide guidance, leadership and oversight of clinical services including authorization of services, clinical operations and the overall clinical direction of Alliance. The Chief Medical Officer is responsible for maintaining the clinical integrity of the program, including oversight of utilization management, quality management, credentialing, utilization management, and best practice guideline development. The Chief Medical Officer may also consult with service providers and other community based clinicians, including general practitioners.

This position is responsible for ensuring delivery of cost effective, quality care that incorporates recovery, resiliency and person-centered services.

Responsibilities:

  • Provide oversight to Utilization Management (UM), Care Coordination, Access and Quality Management staff
  • Provide consultation to providers and other community based clinicians, including general practitioners
  • Responsible for medical necessity review and recommendations, service denial reviews, grievance issues, medication reviews, and clinical best practices guideline development
  • Responsible for achieving appropriate utilization by performing peer reviews and rendering determinations of clinical criteria no longer met for continuation of services; consulting with care management staff; using data to identify opportunities for improvement and implementing strong action plans
  • Responsible for implementing a recovery philosophy, maintaining a knowledge base in rehabilitation and recovery principles and innovations; modeling principles of engagement, empowerment and learning with colleagues and employees, and training all staff in the practical implications of these principles with a particular emphasis on care management, alternative levels of care and network sufficiency
  • Provide clinical leadership to Care Management, Access, Care Coordination and Quality Management staff
  • May provide clinical supervision to clinical staff focusing on medical necessity, reason(s) for continued inpatient services, state requirements, appropriate psychiatric practice and engagement, empowerment, recovery and rehabilitation
  • Provide in service training for staff on managed care and general clinical issues in order for staff to understand direct service vs. care management in a managed care environment
  • May consult with and act as a liaison with area facilities, physicians, and agencies as requested
  • Review reports on UM activities. Complete all medical necessity reviews when Care Managers are unable to authorize inpatient or rehabilitation continued stay. Provide sufficient electronic documentation in the consumer record when a denial is made for either adult or child/adolescent
  • Establish criteria and procedures for the Chief Medical Officer Review of clinical cases. Provide consultation to Alliance Management and staff regarding such issues as clinical standards, policies, procedures, recovery and resiliency and audits

 
Position Requirements

Graduation from an accredited school of medicine and completion of residency or specialty training, board-certified psychiatrist, M.D. or D.O. with an unrestricted clinical license, and four (4) or more years’ experience providing psychiatric services. Must hold an unencumbered North Carolina medical license and be board certified or board eligible in psychiatry.

 
Additional Items Required With Application  
Location Main Office  
Number of Openings 1  
Full-Time/Part-Time Full-Time  
Shift -not applicable-  
Salary Grade 62  
Salary Minimum $192,452  
Salary Maximum $331,302  
Open Date 7/11/2018  
Close Date  
About the Organization Alliance Health manages the public mental health, intellectual/ developmental disability and substance use disorder services for the citizens of Durham, Wake, Cumberland and Johnston counties. Although we do not actually provide services, our job is to ensure that individuals who seek help receive the quality services and supports they are eligible for to help them achieve their goals and live as independently as possible. These services are delivered by a network of private providers who contract with Alliance.  
EOE Statement We are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.  

This position is currently accepting applications.

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