New Leadership Opportunity in Behavioral Health - North Carolina
- Employer
- Enterprise Medical Recruiting
- Location
- North Carolina
- Posted Date
- Mar 23, 2017
- Reference
- JO-1703-71408
View more
- Specialty
- Psychiatry
- Position Type
- Permanent
Job Details
- Applying service definition criteria and other standards of care to requests for services
- Assists the Chief Medical Officer in overseeing the application of medical necessity criteria for service eligibility in regards to type, amount and duration of service; and in developing the process to assess and document medical necessity;
- Reviews the approval and denial of care ensuring protocols are in place and audits are completed by appropriately credentialed staff;
- Assists in functions related to UM, UR, QM, CS, Credentialing, Peer reviews, Appeals, Reconsiderations and the like;
- Assists the Chief Medical Officer in ensuring that a complete utilization management plan is developed and implemented;
- Analyzes and evaluates patient data and test findings to diagnose nature and extent of mental disorders;
- Collaborates with physicians, psychologists, pharmacists, social workers, psychiatric nurses, or other professionals to discuss treatment plans and progress;
- Reviews consumer information and records, including social and medical history obtained from patients, relatives, and other professionals;
- Teaches, participates in continuing education classes, attends conferences and seminars, and may conduct research and publish findings to increase understanding of mental, emotional, and behavioral states and disorders;
- Reviews and evaluates treatment procedures and outcomes of other psychiatrists and medical professionals in the community;
- Provides consultation as well as training and education to staff and community partners on relevant topics;
- Serves as a member of The Credentialing Committee. In the absence of the Chief Medical Officer, the Credentialing Committee may delegate the authority to the Associate Medical Director(s) to review and approve credentialing applications that are complete and meet all requirements set forth in the credentialing plan. The Associate Medical Director will chair the Credentialing Committee in the absence of the Chief Medical Officer;
- Assists in supervision of other members of the Medical team including Physician Peer Reviewer(s), Senior Psychologist, and Pharmacist.
Dave Duncan
800-467-3737
dduncan@enterprisemed.com
www.enterprisemed.com
Job ID#: DD-1703-71408
Company
Enterprise Medical Recruiting, a leading physician, executive and mid-level provider recruiting and consulting firm, connects the most progressive hospitals, clinics and medical groups with the most qualified career-minded candidates. Our clients consist of academic medical centers, integrated delivery systems, multispecialty and single-specialty practices nationwide. Since 1990, Enterprise Medical Recruiting has been leading the market by offering an experienced staff and superior service to provide candidates and healthcare organizations with a positive and successful recruiting experience.
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