Buscar empleo: 117 ofertas de trabajo de medical review physician en Camden, New Jersey (diciembre 2025)

Clinical Care Management Supervisor

hace 25 días

Philadelphia

Job Description The IBHS Clinical Care Management Supervisor for Neurodevelopmental Services is responsible for the daily supervision and oversight of clinical team members. The Clinical Care Management Supervisor must utilize clinical knowledge of best practices and evidence-based treatments, including Applied Behavior Analysis, for individuals with Autism spectrum and other neurodevelopmental disorders, to ensure CBH members receive timely access to quality, medically necessary behavioral health services. When clinically indicated, Clinical Care Management Supervisors participate in clinical rounds, clinical consultation, discharge planning, or inter-agency meetings to support CBH Colleagues, including Physician and Psychologist Advisors, and to ensure the most effective treatment for the CBH member is being authorized. Essential Functions: • Apply advanced knowledge of behavioral health systems, clinical best practices, and medical necessity criteria to all utilization management activities. Conduct expected number of utilization management activities including, but not limited to, interagency meetings, social determinants interviews, treatment team consultations, and care coordination with providers, members, and families. Authorize, extend, or modify treatment services based on clinical documentation, member need, and established criteria., • Consult with Physician Advisor, Psychologist Advisor and/or Clinical Supervisor as clinically appropriate., • Work hands on in the community with members, natural support, and providers., • Facilitate care coordination with system partners to address social determinants, barriers to wellness, and additional related member needs, • Demonstrate an understanding of Evidence-Based Practices (EBPs) and connect members to appropriate evidence-based treatment at admission, during treatment, and at discharge., • Collaborate with other CBH departments to ensure quality of care, promote placement of members in the most appropriate services and to facilitate consistent longitudinal care management., • Participate in supervision, case consultations, and team meetings., • Maintain thorough, timely, and accurate documentation in CBH’s electronic system consistent with regulatory and organizational standards., • Understand and participate in grievance/complaint hearings as assigned., • Respond to care coordination correspondence within 24-48 hours or sooner if necessary., • Work collaboratively with team members including assisting with the training of newly hired employees as requested, covering work when peers are out of the office as assigned and finding coverage when absent., • Build and maintain a strong functional clinical team through effective recruiting, training, performance management, coaching, team building and succession planning., • Manage day to day operations of Clinical Care Managers and other direct reports., • Monitor quality and quantity of reviews and provide feedback., • Collaborate across clinical teams to facilitate and coordinate care., • Collaborate across functional areas of CBH to operationalize changes in policy and procedure., • Develops specific protocols for communication between Clinical Care Managers and other direct reports and providers., • Facilitate internal clinical meetings and external provider meetings., • Accompanies Clinical Care Managers and other direct reports into the community between 15 and 25% of work time to provide ongoing clinical supervision and feedback., • Uses data driven decision making and works to ensure accuracy of member level data and timely communication of data., • Collaborates with other Clinical Supervisors to develop consistent expectations and supervision to Clinical Staff., • Obtains and reviews data relevant to members served by the team, clinical operations and staff monitoring to guide interventions., • Models and requires exceptional customer service in work with members and providers., • Documents supervision notes and next steps consistent with standards in the field., • Perform on-call duties as instructed., • Oversee operations of Clinical Care Managers and other direct reports of the Neurodevelopmental Services Team., • Ensures that team takes an active role in promoting community tenure and other outcomes aligned with CBH’s mission, vision, and strategic plan, • Ensures that Clinical Care managers and other direct reports coordinate with other teams within CBH, including, but not limited to: PES/Crisis Line, Child Acute, Complex Care, and RTF teams, to ensure that longitudinal care is promoted and not disrupted., • Coaches Clinical Care Managers and other direct reports in developing collaborative relationships with system partners, including, but not limited to: DBHIDS, School District of Philadelphia, CUA, Court, and Cross-Systems teams., • Along with ABA and IBHS leadership staff, manage the network of ABA-designated providers and provider-level outcomes per the ABA-designation process and ABA Performance Standards., • Participates in clinical consultation or rounds with teams managing other Levels of Care, (e.g., Child Acute, RTF) to support successful discharge planning and continuity for members moving through levels of care., • Ensures that all direct reports complete thorough and accurate reviews of service authorization requests, including review of Written Orders, Physician consultation per Review Guidelines, provider notification, referral submission (if required), denial letter (if required), authorization generation (if required), and log of review., • Observe and support each direct report, at least once per month, in conducting effective inter-agency or inter-disciplinary team meetings for members being recommended for or receiving ABA Services. Completes QMAT or other staff performance tools, as assigned., • Ensure collaboration and continuity of care for members with multiple services or in multiple child-serving systems., • Facilitate collaboration with community-based treatment team for members experiencing a crisis., • Develops, delivers, and measures the impact of internal CBH trainings, as needed or assigned, to facilitate the appropriate breadth and depth of knowledge of all CBH departments with regards to ABA services and priorities of the Neurodevelopmental Services team., • Develops, delivers, and measures the impact of external CBH trainings as needed or assigned, to support the professional development of staff within ABA network (e.g., hosting or facilitating FBA or skills assessment training, or BACB-approved CEU events)., • Develop schedules and protocols for monitoring ABA network compliance with all applicable regulatory standards (e.g., Chapter 5240 IBHS regs), CBH ABA Performance Standards, and national best practice standards (e.g., BACB Professional and Ethical Compliance Code, APBS Practice Standards., • Develop schedules and protocols for direct reports to conduct progress monitoring reviews for members in need of intensive care management, or as indicated by provider outlier performance. Assists in collection of provider network data, and analysis and presentation of data, in collaboration with Supervisor., • Implement provider management strategies, including review of metrics and key performance indicators, promoting transparent dialogues with all providers with regards to any compliance or outlying performance concerns. Position Requirements: • Education: Master’s degree in Applied Behavior Analysis, Psychology, or Special Education preferred. Master’s degree in a closely related field (e.g., Social Work, Counseling) with at least 18 credits in graduate-level coursework in ABA accepted., • License/Certification: BCBA required, plus one of the following to obtain within the first 18 months (1.5 years) of employment: Licensed Behavioral Specialist, Licensed Professional Counselor, Licensed Marriage and Family Therapist, Licensed Clinical Social Worker, Licensed Social Worker. PA Child Abuse Clearance required., • Relevant Work Experience: At least one year of previous Supervisory experience required. Minimum of 3 years direct clinical experience with children required, with experience in the provision of ABA services to individuals with Autism spectrum or other neurodevelopmental disorders strongly preferred., • Skills:, • Excellent clinical case conceptualization skills, • Ability to positively lead a team and demonstrate solutions-focused culture, • Excellent verbal and written communication skills and ability to use them when communicating with internal and external stakeholders, as well as develop in direct reports, • Excellent time management, organizational, and prioritization skills, including the ability to multi-task in a fast-paced environment, • Excellent meeting facilitation skills, and ability to develop in direct reports, • Proactive planning and efficient use of limited resources (e.g., supplies, time), • Excellent customer service, and ability to develop in direct reports, • Flexibility and positive acceptance of change, • Excellent interpersonal and collaboration skills, • Proficient in MS Office, especially with Excel, and able to type at least 40 words per minute, • Ability to work independently and as part of a team, and to develop in direct reports, • Commitment to professional ethics code (e.g., BACB, APBA), • Requires ability to work shift schedule including days, nights and overnights; schedule may vary., • Requires ability work off-site as needed., • Requires ability to travel, including out-of-state and overnight travel, as needed., • 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. Philadelphia Residency Requirement: • 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.

Trabajos medical review physician en Camden, New JerseyCrear alertas

Búsquedas de empleo más populares en Camden, New Jersey

Lugares de trabajo medical review physician más populares