Behavioral Health Care Manager I
DescriptionSHIFT: Day Job
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 care companies and a Fortune Top 50 Company.
Behavioral Health Care Manager I
Work Location – Remote candidate must reside in PST
Hours are Monday- Friday 9:30-10:30 start time 6:30-7:30 end timePST
Responsible for managing psychiatric and substance use 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 following 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.
• Requires a Master’s degree in social work, counseling, or a degree in nursing
• Requires 3 years of clinical experience providing treatment to individuals with complex psychiatric and or substance use disorder diagnosis in an inpatient or outpatient setting; or any combination of education and experience which would provide an equivalent background.
• Requires Current active unrestricted license to practice as an RN LCSW LPC LMFT or Clinical Psychologist (as allowed by applicable state laws) within the scope of licensure in the state you reside in
• Experience working on multiple computer platforms simultaneously
• Excellent typing skills
• Experience in utilization management
• Experience in managed care
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
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. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
Please be advised that Anthem only accepts resumes from agencies that have a signed agreement with Anthem. Accordingly, Anthem is not obligated to pay referral fees to any agency that is not a party to an agreement with Anthem. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Anthem.