Anthem, Inc. Behavioral Health Care Manager I in Las Vegas, Nevada
SHIFT: 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.
BH Care Manager I Preferred locations are Norfolk, VA or Las Vegas, NV Work Hours: Day Shift The BH Care Manager is primarily a provider facing role although it does involve some member facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care. 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. Provides telephone crisis intervention, assessment, short term problem resolution and referral to appropriate provider(s).
Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing; 3 years of experience with facility-based and/or outpatient psychiatric and substance use 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 LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional. Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
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.