CORONAL
SAGITTAL
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Position Details:
Job Title: Medical Director
Locations: Trenton, NJ 08691
Schedule Notes: Tuesday: 11 am to 4 pm Wednesday: 9 am to 2 pm Thursday: 9 am to 2 pm
Job Description:
The Medical Director is responsible for medical policy pertaining to the quality of behavioral health care. He/she is the designated behavioral health care practitioner with oversight of the Quality Improvement (QI) program. The Medical Director is an active participant in QI Committee meetings providing clinical consultation, and holds final authority for recommendations for medical necessity and appropriateness or quality of care decisions. The PerformCare Quality Improvement (QI) program provides the structure and processes to measure and inform the system of care and key stakeholders of their performance and ability to meet program goals. The Medical Director reviews and approves the Outcomes Management and Quality Improvement Plan.
The Medical Director provides clinical oversight and direction to the Clinical Department. This position is responsible for providing consultation and determinations for clinical cases in need of review. The Medical Director supports the clinical department in applying Medical Necessity Criteria to render determinations for requests for a specific intensity of service. In addition, the Medical Director will assess clinical aspects of specific cases and provide feedback to Care Coordinators and Reviewers pertaining to best practice standards and quality of care issues. This position assists in the development of Medical Necessity Criteria, performs utilization management activities, provides insight into youth outcome trends, and validates Certificate of Need for youth admitted to certain Out of Home providers. Assures that organizational medical policies and procedures adhere to contractual obligations.
The Medical Director has supervisory responsibility over Physician Advisors and Psychologists.
