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Behavioral Health Care Manager Job Family I or II PS19879

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Job Details
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Wilmington, DE 19806
Job Description

Behavioral Health Care Manager Job Family I or II PS19879

Location: North Carolina, United States


Requisition #: PS19879

Post Date: 4 hours 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.

Please Note: This position may be filled at either the Behavioral Health Care Manager I or II. Manager will determine level based upon the selected applicant’s skillset relative to the qualifications listed for this position."

We service our members 24 hours/ 7 days per week. This is a 24 hour/7 day a week center.

Currently we are seeking candidates for full-time positions that will work after hours shifts, this may include weekends, and holidays.

BH Care Manager I

Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. Responsible for integrating into the clinical and care management teams to ensure Member’s behavioral health needs are fully integrated into the service delivery system.

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.

•Provides telephone crisis intervention, assessment, short term problem resolution and referral to appropriate provider(s).

•Receives client request, assesses situation, determines appropriate course of action.

•Assesses members and assists them in accessing behavioral healthcare benefits available under their health plan.

BH Care Manager II

•In addition to the duties for the Level I

•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.

Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing;

3 or more 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, LPC , LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in North Carolina required.

Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.

Prior managed care experience preferred/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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