BH Care Manager II (US)
About the position
The BH Care Manager II position at Elevance Health is a full-time role primarily focused on managing psychiatric and substance abuse treatment benefits for members through telephonic and written reviews. The position requires the individual to utilize their clinical judgment and knowledge of appropriate screening criteria to assess member needs, ensuring access to necessary behavioral healthcare in a cost-effective manner, in accordance with Utilization Management (UM) Clinical Guidelines and contractual obligations. The role involves coordinating assessments, implementing case plans, monitoring progress, and evaluating outcomes to optimize member health benefits and promote effective use of community resources. In addition to managing cases, the BH Care Manager II will serve as a resource for other Behavioral Health Care Managers, assisting with complex cases and participating in interdepartmental projects and initiatives. The position is designed for individuals with a strong background in behavioral health, particularly those with experience in case management and utilization management, and requires a current active unrestricted license to practice as a health professional in applicable states. The work environment is primarily remote, with occasional onsite requirements for onboarding, training, or as directed by management. The position operates on a Monday to Friday schedule from 8:30 AM to 5:00 PM in the Pacific, Mountain, or Central time zones. Candidates must reside within these time zones to be eligible for the role.
Responsibilities
Manage psychiatric and substance abuse treatment benefits through telephonic or written review.
,
Assess member needs using appropriate screening criteria and clinical judgment.
,
Ensure access to medically necessary quality behavioral healthcare in a cost-effective setting.
,
Refer cases to Peer Reviewers as appropriate.
,
Perform psychiatric and substance abuse assessments, coordination, implementation, case planning, monitoring, and evaluation.
,
Promote quality member outcomes and optimize member health benefits.
,
Serve as a resource to other BH Care Managers and assist with complex cases.
,
Participate in inter and intradepartmental teams, projects, and initiatives.
Requirements
MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing.
,
Minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse treatment.
,
Current active unrestricted license such as LCSW, LMSW, LMHC, LPC, LBA, LMFT, or Clinical Psychologist.
,
Previous experience in case management/utilization management with complex psychiatric/substance abuse cases required.
,
Prior managed care experience required.
,
Strong oral, written, and interpersonal communication skills.
,
Problem-solving, facilitation, and analytical skills.
Nice-to-haves
Board Certified Behavioral Analyst (BCBA) if applicable state laws allow.
,
Experience with a broad range of complex psychiatric/substance abuse cases.
Benefits
Employee stock purchase plan
,
Disability insurance
,
Health insurance
,
Dental insurance
,
401(k)
,
Paid time off
,
Vision insurance
,
401(k) matching
,
Life insurance
Apply Now
The BH Care Manager II position at Elevance Health is a full-time role primarily focused on managing psychiatric and substance abuse treatment benefits for members through telephonic and written reviews. The position requires the individual to utilize their clinical judgment and knowledge of appropriate screening criteria to assess member needs, ensuring access to necessary behavioral healthcare in a cost-effective manner, in accordance with Utilization Management (UM) Clinical Guidelines and contractual obligations. The role involves coordinating assessments, implementing case plans, monitoring progress, and evaluating outcomes to optimize member health benefits and promote effective use of community resources. In addition to managing cases, the BH Care Manager II will serve as a resource for other Behavioral Health Care Managers, assisting with complex cases and participating in interdepartmental projects and initiatives. The position is designed for individuals with a strong background in behavioral health, particularly those with experience in case management and utilization management, and requires a current active unrestricted license to practice as a health professional in applicable states. The work environment is primarily remote, with occasional onsite requirements for onboarding, training, or as directed by management. The position operates on a Monday to Friday schedule from 8:30 AM to 5:00 PM in the Pacific, Mountain, or Central time zones. Candidates must reside within these time zones to be eligible for the role.
Responsibilities
Manage psychiatric and substance abuse treatment benefits through telephonic or written review.
,
Assess member needs using appropriate screening criteria and clinical judgment.
,
Ensure access to medically necessary quality behavioral healthcare in a cost-effective setting.
,
Refer cases to Peer Reviewers as appropriate.
,
Perform psychiatric and substance abuse assessments, coordination, implementation, case planning, monitoring, and evaluation.
,
Promote quality member outcomes and optimize member health benefits.
,
Serve as a resource to other BH Care Managers and assist with complex cases.
,
Participate in inter and intradepartmental teams, projects, and initiatives.
Requirements
MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing.
,
Minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse treatment.
,
Current active unrestricted license such as LCSW, LMSW, LMHC, LPC, LBA, LMFT, or Clinical Psychologist.
,
Previous experience in case management/utilization management with complex psychiatric/substance abuse cases required.
,
Prior managed care experience required.
,
Strong oral, written, and interpersonal communication skills.
,
Problem-solving, facilitation, and analytical skills.
Nice-to-haves
Board Certified Behavioral Analyst (BCBA) if applicable state laws allow.
,
Experience with a broad range of complex psychiatric/substance abuse cases.
Benefits
Employee stock purchase plan
,
Disability insurance
,
Health insurance
,
Dental insurance
,
401(k)
,
Paid time off
,
Vision insurance
,
401(k) matching
,
Life insurance
Apply Now