Job Information
CDPHP Behavioral Health Medical Director, Children’s Services (PT) in Albany, New York
Grounded by a compelling mission, core values, and compassion for people, CDPHP and its family of companies offer a strong foundation for a rewarding career. Established in 1984, CDPHP is a physician-founded, member-focused, and community-based not-for-profit health plan that offers high-quality affordable health insurance to members throughout New York. The company values people, quality, innovation, and community, and its corporate culture supports those values wholeheartedly. CDPHP is committed to fostering a culture of belonging and takes a wholistic approach to diversity, equity, and inclusion. At CDPHP, the employees have a voice and are encouraged to make an impact at both the company and community levels through engagement and volunteer opportunities. CDPHP invests in employees who share these values and invites you to be a part of that experience.
The Medical Director, Behavioral Health, Child & Adolescent Programs will conduct utilization review oversight, guidance and determinations for behavioral health services across all lines of business. In addition, the Medical Director will be assigned to oversee the unique needs of CDPHP members 21 years of age and younger. The Medical Director also works with other plan staff to integrate plan benefits to improve the overall health of the membership.
This is a part-time position with a potential range of 20 - 30 hours/week.
Qualifications:
MD or DO required. Must possess, or pursue upon hire, a current, active, NY State license to practice medicine without restrictions.
Board Certified in Child and Adolescent Psychiatry with experience in addiction and adult psychiatry.
Minimum of (5) five years post residency practice experience is required, including significant exposure to practicing in a managed care environment and at least 2 years in a clinical care setting.
Appropriate training and experience in Child and Adolescent Psychiatry with preference for experience in providing psychiatric services to child and adolescents participating in the Home and Community Based Service Waiver Programs:
Office of Mental Health (OMH) Serious Emotional Disturbance (SED) waiver
Department of Health (DOH) Care At Home (CAH) I/II waiver
Office of Children and Families (OCFS) Bridges to Health (B2H) SED
OCFS B2H Developmental Disability (DD) waiver
OCFS B2H Medically Fragile waiver
Experience with critical review in clinical scenarios, such as peer review, is essential.
Knowledge of and experience with NCQA requirements and HEDIS reporting is desirable as is training and/or prior experience with the Continuous Quality Improvement concept.
Understanding of Microsoft Word, Excel, Outlook and PowerPoint is required.
Knowledge of claims management systems is preferred.
Ability to learn new systems as needed for Medical review is required.
Flexibility to adapt to a changing and fast-paced environment is required.
Ability to shift priorities as needed while maintain professionalism is required.
Demonstrated ability to work independently, assume responsibility and implement proactive solutions is required.
Ability to work with and maintain confidential information required.
Remote work arrangement may be considered; must have the ability for an occasional presence in CDPHP headquarters in Albany, NY.
Must be available to attend all CDPHP and State mandated meetings.
CDPHP salary ranges are designed to be competitive with room for professional and financial growth. Individual compensation is based on several factors unique to each candidate, such as work experience, qualifications, and skills. In addition to cash compensation, CDPHP employees may be eligible for an incentive payment, a discretionary cash reward based on employee and company performance. Some roles may also be eligible for overtime pay.
CDPHP compensation packages go far beyond just salary. The company offers a comprehensive total rewards package that includes award-winning health care coverage, health care dollars, a generous paid time off allowance, employee assistance programs, flexible work environment, and much more. Learn about all CDPHP employee benefits at https://www.cdphp.com/about-us/jobs/benefits .
As an Equal Opportunity / Affirmative Action Employer, CDPHP will not discriminate in its employment practices on the basis of race, color, creed, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship, disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, protected veterans status, or any other characteristics protected under applicable law. To that end, all qualified applicants will receive consideration for employment without regard to any such protected status.
CDPHP and its family of companies include subsidiaries Strategic Solutions Management Consultants (SSMC), Practice Support Services (PSS), and ConnectRx Services, LLC.
