Behavioral Health Care Manager II (Western U.S.A.) PS20328
Location: United States
Requisition #: PS20328
Post Date: 23 hours ago
YourTalent. Our Vision. At Anthem, Inc., it's
a powerful combination, and the foundation upon which we're creating greater access
to care for our members, greater value for our customers, and greater health
for our communities. Join us and together we will drive the future of healthcare .
This is an
exceptional opportunity to do innovative work that means more to you and those
we serve at one of America's leading health benefits companies and a Fortune
Top 50 Company.
BehavioralHealth Care Manager I/II
Position will be filled at level ofexperience of candidate selected.
WorkLocation - Western United States: Open to work from home, or any Anthem Office
Responsible for managing psychiatric and substance abuse or
substance abuse disorder facility-based and outpatient professional treatment
health benefits through telephonic or written review. Primary duties may
include but are not limited to:
- Uses appropriatescreening criteria knowledge and clinical judgment to assess member needsto ensure access to medically necessary quality behavioral healthcare in acost effective setting in accordance with UM Clinical Guidelines andcontract.
- Refers cases toPeer Reviewers as appropriate.
- Performspsychiatric and substance abuse or substance abuse disorder assessmentcoordination implementation case planning monitoring and evaluating topromote quality member outcomes to optimize member health benefits and topromote effective use of health benefits and community resources.
- Will serve as aresource to other BH Care Managers.
- Assists withmore complex cases and may participate in inter and intradepartmentalteams projects and initiatives.
social work counseling or a related behavioral health field or a degree in
nursing; 3-4 years of experience with facility-based and/or outpatient
psychiatric and substance abuse or substance abuse disorder treatment; or any
combination of education and experience which would provide an equivalent
background. Current active unrestricted license as an RN LCSW LMSW LMHC LPC LBA
(as allowed by applicable state laws) LMFT or Clinical Psychologist to practice
as a health professional within the scope of licensure in applicable states or
territory of the United States required. Previous experience in case management/utilization
management with a broad range of experience with complex psychiatric/substance
abuse cases required. Prior managed care experience required. Experience
working with Microsoft Office (Outlook, Word, and Excel). Experience working with electronic databases,
multiple PC's, data entry, and typing. For
URAC accredited areas the following applies: Requires strong oral, written and
interpersonal communication skills, problem-solving skills, facilitation
skills, and analytical skills.
Anthem, Inc.is ranked as one of America's Most Admired Companies among health insurers byFortune magazine and is a 2018 DiversityInc magazine Top 50 Company forDiversity. To learn more about our company and apply, please visit us atcareers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.