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Behavioral Health Care Manager (Job Family) PS23797

Anthem Winston-Salem, NC
  • Expired: 5 days ago. Applications are no longer accepted.
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Your Talent. Our Vision. At Healthy Blue, a strategic alliance of Blue Cross NC and Amerigroup, an Anthem Inc. company, 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, II, III, Lead (Job Family)

This position may be filled at either the BH Care Manager I, II, II or Lead level.

Manager will determine level based upon the selected applicant's skillset relative to the qualifications listed for this position.

Location: New location in Greensboro/Winston Salem North Carolina.




This is a 24 hour/7 day a week center.

We service our members 24 hours/ 7 days per week.

Currently we are seeking candidates for full-time positions that will work shifts within operational hours, this may include nights, weekends, and holidays.

BH Care Manager I

Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. Responsible for integrating into the clinical and care management teams to ensure Member's behavioral health needs are fully integrated into the service delivery system.

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.

• Provides telephone crisis intervention, assessment, short term problem resolution and referral to appropriate provider(s).

• Receives client request, assesses situation, determines appropriate course of action.

• Assesses members and assists them in accessing behavioral healthcare benefits available under their health plan.

BH Care Manager II

• In addition to the duties for the Level I

• 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.

BH Care Manager III

• In addition to the duties for the Level I & level II

• Will serve as an assistant to the BH Care Manager Lead in implementing identified operational processes.

• Will develop expertise in specified areas of business needs to assist management with unit operations.

• May act as lead in the leads absence.

BH Care Manager Lead

Responsible for coordinating workflows for care management of 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:

• Coordinating utilization management process including appropriate use of UM Clinical Guidelines to refer cases to Peer Reviewers.

• Implements and monitors care management programs for complex cases.

• Coordinates with internal and external resources to meet the identified needs of members.

• Functions as resource to other BH Care Managers regarding the monitoring of all aspects of members' behavioral health needs.

• Conducts audits and serves as senior member in care management unit.

• Will serve as a resource to other BH Care Managers regarding care management workflow.

• Assists with more complex cases and participates in inter and intradepartmental teams projects and initiatives.

• Assists in training/mentoring of new hires.

BH CMI, II, or III

Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing;

3 or more 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, LPC , LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in North Carolina required.

Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.

Prior managed care experience preferred/required.

BH Care Manager Lead:

Requires MS or MA in social work counseling or related behavioral health field or a degree in nursing;

5+ 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, LPC , LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in North Carolina 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.

The following applies to all levels:

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 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.

Anthem

Address

Winston-Salem, NC
USA