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BH Case Mgr II

This job posting is no longer active.

Location: Nashville, TN
Job Family: Medical
Req #: PS37903-Nashville-Nashville
Date Posted: Oct 15, 2020

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s 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.
 
 
We are hiring for multiple positions in the following locations:
 
CA: Sacramento, San Francisco
IN: Indianapolis
 
 
These are field based positions that will be located in metro areas listed with up to 75% of local travel.
 
Note: Temporarily not doing field work. Telephonic outreach only due to the COVID-19 pandemic.
 
 
Behavioral Health Case Manager II is responsible for performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health, physical health and substance abuse or substance abuse disorder needs.
 
Primary duties may include but are not limited to:
  • Completes face-to-face visits with the member in the home, hospital, and other community settings, such as doctor's offices, treatment centers, etc. (Temporarily outreach is telephonic only due to the pandemic.)
  • Responds to more complex cases and account specific requests. 
  • Uses appropriate screening criteria knowledge and clinical judgment to assess member needs.
  • Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment.
  • Monitors and evaluates effectiveness of care plan and modifies plan as needed.
  • Supports member access to appropriate quality and cost effective care.
  • Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers.
  • Identifies members at high risk for complications and coordinates care in conjunction with the member and the health care team.
  • Identifies members that would benefit from an alternative level of care or other waiver programs.
  • Assists in problem-solving with providers and the health care team.
  • Serves as a resource to other Case Managers.
  • Participates in cross-functional teams projects and initiatives.

Qualifications

Must be located in one of the following locations and have the ability to travel (temporarily telephonic only due to the COVID - 19 pandemic) up to 75%:
 
CA: Sacramento, San Francisco
IN: Indianapolis
 
 
Qualifications:
  • Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing; 3- 4 years of clinical experience in social work counseling with broad range of experience with complex psychiatric, complex medical 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, LMHC, LPC (as allowed by applicable state laws), LMFT, LAPC, LAMFT, LMSW (as allowed by applicable state laws), or Clinical Psychologist to practice as a health professional within the scope of licensure in the applicable state is required.
  • Previous experience in case management and telephonic and/or in person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders.
  • Managed care experience required.
  • Experience in health coaching and motivational interviewing techniques preferred.
  • Experience working in a field based position.
 
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
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