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Behavioral Health Case Mgr II - Las Vegas, NV - PS12542 in Las Vegas, NV at Anthem, Inc.

Date Posted: 11/29/2018

Job Snapshot

Job Description

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.

Behavioral Health Nurse Case Manager II


Please note: The BH Case Mgr. (CM) job progression is primarily member facing and involves complete clinical assessment.

The Behavioral Health Nurse Case Manager II is responsible for performing face to face and telephonic case management within the scope of licensure for members with behavioral health and physical health substance abuse or substance abuse disorder needs. Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED), Maternity, Alcohol / Drug, Autism Spectrum Disorders (ASD), etc.  Primary duties may include, but are not limited to:

  • Face to face visits with the member that include home visits, hospital and other community settings such as doctor's office, treatment centers, etc.
  • Responds to more complex cases and account specific requests.
  • Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs.
  • Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment.
  • Monitors and evaluates effectiveness of care plan and modifies plan as needed.
  • Supports member access to appropriate quality and cost effective care.
  • Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers.
  • Serves as a resource to other Behavioral health and physical health Case Managers.
  • Participates in cross-functional teams, projects and initiatives.
  • Responsible for performing telephonic and face-to-face clinical assessments for the identification, evaluation, coordination and management of member's needs, including physical health, behavioral health, social services.
  • Identifies members for high risk complications and coordinates care in conjunction with the member and the health care team.
  • Support members with chronic illnesses, co-morbidities, and/or disabilities, to insure cost effective and efficient utilization of health benefits.
  • Obtains a thorough and accurate member history to develop an individual care plan. 
  • Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, physicians; identifies members that would benefit from an alternative level of care or other waiver programs.
  • Will assist in problem solving with providers and the health care team.

  • Degree in nursing, MS or MA in social work, counseling, or a degree in related behavioral health field 
  • 3- 4 years of clinical experience in social work, counseling with broad range of experience with complex 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, LMHC, LPC, LMSW, LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in Nevada required.
  • Previous experience in case management and face to face and telephonic coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders.
  • Managed care experience preferred.
  • Experience in health coaching and motivational interviewing techniques preferred.
  • Home visit experience is strongly preferred
  • Problem solving mentality
  • Great written and verbal communication
  • Proficient in Microsoft Office
  • Computer literate
  • Proficient typing skills
  • Must live within the Las Vegas, Nevada area
  • Ability to travel will be 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 An Equal Opportunity Employer/Disability/Veteran.


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