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BH Care Manager I, II, or III Job Family PS16851

Anthem Ashburn, VA
  • Posted: February 02, 2019

BH Care Manager I, II, or III Job Family PS16851 **New** **Location:** **Norfolk, Virginia, United States** **Field:** Medical **Requisition #:** PS16851 **Post Date:** 1 day 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, II, or III Job Family Please note: this position can be filled at either the BH Care Manager Level I, II, or III depending on qualifications and experience and is at the discretion of the manager.** Locations Considered: Norfolk, VA Office Nevada - Remote within the state 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 and medical necessity criteria for behavioral health impatient and outpatient levels of care. Demonstrates 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. Completes retro reviews as well as current/live reviews. 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. 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 will participate in inter and intradepartmental teams projects and initiatives. 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 lead's absence. BH Care Manager I, II, or III Job Family Please note: this position can be filled at either the BH Care Manager Level I, II, or III depending on qualifications and experience and is at the discretion of the manager.** BH Care Manager I Requires MS or MA in social work counseling or a related behavioral health field. 3 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, LPC, 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. Experience working with Microsoft Office(Outlook, Word and Excel) Experience working with electronic databases, multiple PC's, data entry, and typing. Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Experience using Facets and Macess is preferred. Bilingual preferred. BH Care Manager II Requires MS or MA in social work counseling or a related behavioral health field. 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, LPC, 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. Experience working with Microsoft Office(Outlook, Word and Excel). Experience working with electronic databases, multiple PC's, data entry, and typing. 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 using Facets and Macess is preferred. Bilingual preferred. BH Care Manager III Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing 4-5 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 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. 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.

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