Anthem In. Case Management Jobs

Job Information

Anthem, Inc. Behavioral Health Care Manager Lead in Cerritos, California

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, 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.

For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

Position: BH Care Manager Lead Location: Cerritos, CA or remote in CA

The BH Care Manager Lead is responsible for participating in clinical rounds, providing consults related to readmission and length of stay issues, coordinating workflows for utilization management of 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:

  • Coordinating utilization management process including appropriate use of UM Clinical Guidelines to refer cases to Peer Reviewers.

  • Implements and monitors care management programs for complex cases.

  • Coordinates with internal and external resurces to meet the identified needs of members.

  • Functions as resource to other BH Care Managers regarding the monitoring of all aspects of members' behavioral health needs.

  • Conducts audits and serves as senior member in care management unit.

  • Will serve as a resource to other BH Care Managers regarding care management workflow.

  • Assists with more complex cases and participates in inter and intradepartmental teams projects and initiatives.

  • Assists in training/mentoring of new hires.

  • Assists in departmental reporting responsibilities and time sensitive deliverables

  • Other duties as assigned

Qualifications

  • Education: MS or MA in social work, counseling, or related behavioral health field or a degree in nursing required

  • Experience: 5+ years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment required

  • Prior managed care experience required.

  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.

  • Licensure: Current active unrestricted license in the state of CA such as RN, LCSW, LMSW, LMHC, LPC, LMFT, or clinical Psychologist to practice as a health professional within the scope of licensure

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: PS43822

DirectEmployers