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Behavioral Health Care Manager, Utilization Management - Richmond, Virginia  PS14829 in Richmond, VA at Anthem, Inc.

Date Posted: 11/9/2018

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

Location:  Richmond, Virginia.

The BH Care Manager (Utilization Management) 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.  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 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.


  • Virginia residency required.
  • Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing
  • Current active unrestricted license as an LCSW, LPC, LMFT, or RN from the state of Virginia required.
  • 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment.
  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
  • Previous experience in rehabilitation services preferred.
  • Must be proficient in Microsoft Office products.


Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2015 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at antheminc.com/careers.
AnEqualOpportunityEmployer/Disability/Veteran




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