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Behavioral Health Care Manager I/II - Mason, OH in Mason, OH at Anthem, Inc.

Date Posted: 8/10/2018

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.

BH Care Manager I, II

Location: Mason, OH

**This position can be filled at either the level I or II level depending on qualifications and business needs.**

BH Care Manager I

The BH Care Manager (UM) job progression is primarily a provider facing role although it does involve some member facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care.

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. 

BH Care Manager II

The BH Care Manager (UM) job progression is primarily a provider facing role although it does involve some member facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care.

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.


Qualifications:

BH Care Manager I
  • Requires MS or MA in social work, counseling, or a related behavioral health field or a degree in nursing and 3 years 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 a LISW, PCC, RN, 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 or an acute care setting, with a broad range of experience with complex psychiatric/substance abuse cases preferred.
  • Proficient in Microsoft office
  • Advanced typing skills and computer literacy

BH Care Manager II
  • Requires MS or MA in social work, counseling, or a related behavioral health field or a degree in nursing and 3-4 years 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 a LISW, PCC, RN, or clinical psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.
  • Proficient in Microsoft office
  • Advanced typing skills and computer literacy
  • Previous experience in case management/utilization management or an acute care setting, with a broad range of experience with complex psychiatric/substance abuse cases required.
  • Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
  • 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