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Behavioral Health Care Manager...

Monster
 
 
 
 

Job Summary

Company
Anthem
Location
Eagan, MN
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_PS2783

Behavioral Health Care Manager Utilization Management Licensed (i.e. RN, LCSW, LMSW, LMHC, LPC, P...

About the Job

Description
Your Talent. Our Vision. At Anthem, Inc., the Government Business Division is focused on serving Medicaid, Medicare and uninsured individuals. Our commitment and focus on government health programs is the foundation upon which we're creating better care for our members, greater value for our customers and better health for our communities. Join us and together we will drive the future of health care.
Join one of the fastest growing businesses in a company with the largest and most successful Medicaid business in the nation. The associate in this position will be supporting members enrolled in the Minnesota Medicaid Program.

Behavioral Health Care Manager Utilization Management Level I/II/III (Job Family) Eagan, MN PS2783

Work Location: Eagan, Minnesota
This is an office based position - Monday-Friday 8 a.m. - 5 p.m.

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.

Level II:
* 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.

Level III:
* Will serve as a resource to other BH Care Managers.
* Assists with more complex cases and will participate in inter and intradepartmental teams projects and initiatives.
* Will serve as an assistant to the BH Care Manager Ld in implementing identified operational processes.
* Will develop expertise in specified areas of business needs to assist management with unit operations.
* May act as lead in the lead's absence.

Please note: The BH Care Manager (UM) job progression is primarily a provider facing role although it may 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.
Qualifications
Level I:
* Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing;
* 3 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.
* Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.

Level II:
* Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing;
* 3-4 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.
* Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.
* Prior managed care experience required.

Level III:
* Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing;
* 4-5 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.
* Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.
* Prior managed care experience required.

Key Qualifications:
* Utilization Management Experience
* Experience working with Children/Adolescents and Adults.
* Current active unrestricted license as an RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in the state of Minnesota required.
* Managed Care experience.
* Community Mental Health experience; knowledge of state resources.

Note: This position may be filled at the BH Care Manager I, II or III level. The manager will determine level based upon the selected applicant's skillset relative to the qualifications listed for this position.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

 

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