BH Care Manager I, II or III Job Family PS28497
**Location:** **Albany, New York, United States**
**Requisition #:** PS28497
**Post Date:** 4 hours ago
Your Talent. 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 health care.
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.
BH Care Manager I or II or III
This position can be filled at either a level I, II, or III. Manager will determine level based upon the selected applicant's skill set relative to the qualifications listed for this position.
BH Care Manager I, II or III
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 appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract.
Refers cases to Peer Reviewers as appropriate.
Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.
Will serve as a resource to other BH Care Managers. Assists with more complex cases and may participate in inter and intradepartmental teams projects and initiatives. (Level II and III)
Assists with more complex cases and will participate in inter and intradepartmental teams projects and initiatives. (Level III)
Will serve as an assistant to the BH Care Manager Ld in implementing identified operational processes. (Level III)
Will develop expertise in specified areas of business needs to assist management with unit operations. (Level III)
May act as lead in the leads absence. (Level III)
BH Care Manager I, II or III
Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing
A minimum of 3 years of experience with facility-based and/or outpatient psychiatric and or substance use disorder treatment
o Or any combination of education and experience which would provide an equivalent background.
Current active unrestricted license as an RN LCSW 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 preferred for Level I
Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Must live within one hour of an Anthem office
Medicare and/or Medicaid experience preferred
Able to meet deadlines
Has accountability and time management in order to meet the federal guide lines
Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required. (Level II and III)
Prior managed care experience required. (Level II and III)
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.