Bi-Lingual Behavioral Health Care Manager I
DescriptionSHIFT: Night Job
Be part of an extraordinary team!
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving high-performance culture that empowers you to make an impact?
Bi-Lingual Behavioral Health Care Manager I
**must speak, write, and read English and Spanish**
Work Hours: Non-traditional schedule (Week 1): Tue – Fri. 5pm-3:30am EST (Week 2) Mon 5pm-5:30am & Sat/Sun 7:30am-8pm EST
Location: Remote – work from home
Licensure Required: RN, LCSW, LPC, LMHC, or LMFT to practice as a health professional within the scope of licensure in the state of North Carolina.
Sign on bonus of 1,500 included.
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.
- Requires MA/MS in social work, counseling or a related behavioral health field or a degree in nursing.
- Requires a minimum of 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 such as RN, LCSW, LPC, LMHC, or LMFT to practice as a health professional within the scope of licensure in the state of North Carolina.
- Must reside and be licensed in North Carolina.
- Bi-Lingual (speak, write and read English and Spanish)
- Previous experience in utilization management reviews with a broad range of experience with complex psychiatric/substance abuse cases preferred. Associates with strong oral, written and interpersonal communication skills in English & Spanish, problem-solving skills, facilitation skills, and analytical skills.
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.
The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Anthem approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Applicants who require accommodation to participate in the job application process may contact [email protected] for assistance.
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.