Chief Psychiatric Medical Officer

This full time position will require employees to in the office (D.C.) four (4) days a week.

Must be authorized to work in the United States. Visa sponsorship is available for qualified candidates.

The Chief Psychiatric Medical Officer (CPMO) is the leader for mental health/behavioral health within Health Services for Children with Special Needs, Inc (HSCSN). HSCSN is a small, Medicaid Managed Care Organization (health plan) that is contracted with the District of Columbia to administer the Child and Adolescent Supplemental Security Income Program (CASSIP). Medicaid enrollees are eligible for CASSIP if they are between 0 and 26 years and have Supplemental Security Income (SSI) or are considered SSI-eligible. HSCSN is an integrated health plan, providing both physical health and behavioral health services. HSCSN is part of the HSC Health Care System.

The CPMO must be a psychiatrist who is board-certified in Child and Adolescent Psychiatry and licensed to practice medicine in the District of Columbia. CPMO responsibilities parallel those of the Chief Medical Officer (CMO) with respect to enrollees with behavioral health conditions, mental illness, or substance abuse disorders. The CPMO participates in organization-wide strategic, medical and business planning as well as goal setting related to mental/behavioral health. Works as clinical leader for behavioral health services for the four clinical departments, i.e. Medical Affairs, Care Management (CM), Utilization Management (UM), and Quality Management. Works with UM and CM staff to ensure that HSCSN enrollees receive medically appropriate, timely, effective and coordinated heath care services to address mental/behavioral health needs. Collaborates with the CMO, CQO, Quality Management staff and Care Management Department to monitor and evaluate the quality of behavioral health services being delivered to HSCSN members by network mental/behavioral health providers. As an executive of HSCSN, serves as a leader and clinical liaison with HSCSN network mental health providers and communicates with behavioral health agencies and regulatory entities on behalf of HSCSN.

Minimum Education
Medical Doctor (M.D.) (Required)
Residency in Psychiatry (Required)

Minimum Work Experience
3 years at least three years of clinical practice as a child and adolescent psychiatrist (Required)
Work experience with a managed care organization (Preferred)
Experience with regulatory accreditation requirements preferred (Preferred)

Required Licenses and Certifications
Must be a physician with a current license to practice medicine without restriction in the District of Columbia (Required)

Board Certification in Child and Adolescent Psychiatry (Required)

Required Skills/Knowledge
Familiarity with Medicaid system.
Experience with SSI eligible population.
Expertise in residential treatment for youth.
Multidisciplinary team leadership.

Job Functions
Essential job duties:

• Leads and manages HSCSN's mental/behavioral health activities and clinical programs.

• Monitors ongoing mental/behavioral health activities and clinical service delivery by the HSCSN provider network.

• Provides guidance and supervision in the development of HSCSN protocols, policies and procedures pertinent to mental/behavioral operations.

• Advises care management staff related to behavioral health diagnoses, services, and care coordination.

• Holds regular Behavioral Health Rounds with medical management staff to address behavioral health concerns of individual enrollees.

• Advises utilization management staff about appropriate authorizations and protocols and participates in the development of guidelines delegating the authorization of certain mental/behavioral health benefits.

• Provides second-level review for the Utilization Management Department related to pre-service, concurrent, and post-service authorization decisions for behavioral health services. Provides second-level review for all adverse benefit determinations related to behavioral health services.

• Ensures HSCSN enrollee medical records are reviewed when staff express concerns related to mental/behavioral health care involving clinical appropriateness, quality of care and service, effectiveness of outcomes, potential provider fraud/abuse, provider competency, etc.

• Oversees and coordinates the credentialing of physicians and other mental/behavioral health care providers and entities.

• Participates as a leader in preparation for and during actual accreditation surveys and regulatory agency audits (e.g. JCAHO, NCQA, DelmarvaQlarant, Medicaid, HCFACenters for Medicare & Medicaid, DC DHCF, DC DCRA, DC DISB, etc.)

• Participates in education of the Network mental/behavioral health providers as it relates to the unique mental/behavioral health needs of children/youth, current trends in the care of this population and ways of improving care and services.

• Serves as liaison between enrollees and the network mental/behavioral health providers when necessary.

• Participates in the design of data sets and control measures that provide information essential for effective quality management of mental/behavioral health services.

• Provides input into new and renegotiated mental/behavioral health providers contracts.

• Represents HSCSN leadership, board of directors, HSCSN mission, values and goals to Network mental/behavioral health providers.

• Is available to perform his/her function during normal business hours and accessible via HSCSN cell phone 24/7 (when not on PTO), to respond to all attempts to contact him/her in a timely manner for urgent /emergent business matters.

• Participates in peer to peer discussions with relevant physicians as necessary.

• Assists in the practitioner appeal reviews, appropriateness criteria reviews, medical policy and technology assessments, setting and implementing QI initiatives and practitioner/provider credentialing.

• Leads, develops, directs and implements clinical and non-clinical activities that impact health care quality cost and outcomes.

• Serves as the chair of the Residential Placement Committee. Participates as a member of the committee in decisions relating to placement of patients in residential treatment facilities.

• Serves as a Co-Chair of the Benefits & Utilization Management Committee (BUMC) and the Credentialing Committee, as a member of the Quality Management Oversight Committee, Appeals & Grievances Committee, Enrollee Safety/Risk Management Committee, and various other HSCSN and DHCF Committees as appropriate.

Other job duties:

• May perform other duties in addition to those outlined in this job description.

Organizational Accountabilities
Organizational Accountabilities (Managers)
Leadership Excellence

• Demonstrates understanding of quality of service and collaborates with co-workers to ensure excellence is achieved

• Innovates through improvement of care and/or efficiency of operational processes.

• Dedicated to a standard of performance excellence and high quality

Collaboration

• Creates a safe environment that encourages brainstorming, creativity and "out-of-the-box" thinking

• Encourages a diverse group of people to communicate effectively and embrace creative thinking

• Drives the collaborative efforts of the team to achieve goals in the most effective and efficient way

• Demonstrates listening and feedback skills

Leadership Skills

• Proactively assumes responsibility and accountability for results to include management of organizational change

• Empowers staff in ensuring a culture of transparency, fairness, respect and excellence

• Strategically aligns operational and tactical objectives to drive business results.

• Encourages collaboration with team members based on trust, mutual respect, consistent visible support, and open and honest communication.

Supervisory Responsibilities

• The incumbent will be responsible for the general direction of staff member(s).

Blood Borne Pathogen Exposure

• Category II: Job may expose incumbent occasionally or in emergency situations to blood, body fluids, non-intact skin or tissue specimens.

Protected Health Information Access Level

• Level IV - Full Access Incumbents in this job may access any protected health information associated to a customer's needs, the service(s) rendered and the position's functions.

Working Environment

• This job operates in an office environment.

Physical Requirements

• Sedentary Work: Lifting 10 lbs. maximum and occasionally lifting and/or carrying such articles as dockets, ledgers and small tools. Although a sedentary job is defined as one that involves sitting, a certain amount of walking and standing is often necessary in carrying out job duties. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Travel Requirements

• Frequent travel requirements for this position. The incumbent should have a vehicle or access to a motor vehicle.

DC Residents Encouraged to Apply