Anthem In. Case Management Jobs

Job Information

Anthem, Inc. Dir Behavioral Health Services in Cary, North Carolina

Description

SHIFT: Day Job

SCHEDULE: Full-time

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.

We are hiring for a Director of Behavioral Health Services. Responsible for directing a state behavioral health services function. Responsible for one state depending on size and complexity of the contract.

Primary duties may include, but are not limited to:

Ensures appropriate utilization of various Inpatient and outpatient Behavioral Health services.

Ensure Case Management services delivered by the Case Management team are person centered and meets needs of members

Will lead team(s) of clinicians providing direct care services. Directs assessments, provides appropriate referrals, and performs follow up to ensure the quality and appropriateness of services.

Develops and maintains a positive relationship with providers, advocates and state partners and works to maintain quality outcomes, proper billing, and coordination of care.

Leads and participates in cross-functional corporate teams which design and implement new care/case/utilization management programs.

Develops and implements process and program redesigns.

Leads multiple teams of clinicians charged with promoting quality member outcomes, to optimize member benefits, and to promote effective use of resources.

Ensures adherence to all contract, regulatory and accreditation requirements.

Develops short/long-term objectives and monitors processes and procedures to ensure consistency with the enterprise and compliance with state and federal regulations. Collaborates with Care Management partners to resolve issues or find solutions.

Manages budget and special projects. Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Qualifications

Requires a MS in a mental health field (i.e. social work, counseling) or related field (i.e. nursing)

10 years of clinical experience including case management and leadership experience; or any combination of education and experience, which would provide an equivalent background.

Current unrestricted license for specific profession (i.e. LCSW, RN,) as required. For URAC accredited areas the following applies:

Requires strong oral, written and interpersonal communication skills, 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.

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.

REQNUMBER: PS45519

DirectEmployers