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Behavioral Health Manager (Beh...

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Job Summary

Company
Anthem
Location
Denver, CO
Industries
Other/Not Classified
Job Type
Full Time
Employee
Career Level
Experienced (Non-Manager)
Job Reference Code
4298_139774

Behavioral Health Manager (Behavioral Health Care Manager I/II) Colorado Springs (SIGN-ON BONUS)...

About the 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.


$1,000 sign-on bonus offered for this role!

Location: This position will train in our Colorado Springs area office location. Remote work may be possible 3-9 months after training.


The BH Care Manager I is 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 and ensures access to medically
  • necessary quality behavioral healthcare in a cost effective setting in
  • accordance with UM Clinical Guidelines and contract.
  • Prepares case summary and 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.
  • Performs all tasks in compliance with policies and procedures and accreditation guidelines.

The BH Care Manager II is 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.
  • Prepares case summary and 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.
  • Performs all tasks in compliance with policies and procedures and accreditation guidelines.
  • Serves as a resource to other BH Care Managers.
  • Assists with more complex cases and may participate in inter/intradepartmental teams projects and initiatives.



Qualifications

Requirements for BH Care Manager I

  • MS or MA in social work, counseling, or a related behavioral health field degree or Master's 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.
  • Current active unrestricted license to practice independently as an RN, LCSW, LPC, LMFT, or LAC (as allowed by applicable state laws) 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 with a broad range of experience with complex psychiatric/substance abuse cases preferred.
  • Previous experience in managed care and/or Medicaid preferred.


Requirements for BH Care Manager II

  • MS or MA in social work, counseling, or a related behavioral health field or a Master's 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.
  • Current active unrestricted license to practice independently as an RN, LCSW, LPC, LMFT, or LAC (as allowed by applicable state laws) 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 with a broad range of experience with complex psychiatric/substance abuse cases required.
  • Previous experience in managed care and/or Medicaid strongly preferred.



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 and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.


 

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