Anthem, Inc. BH Case Mgr II (Albemarle County) in Lexington, Virginia
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.
Please note: The BH Case Mgr (CM) job progression is primarily member facing and involves complete clinical assessment. Whereas the BH Care Manager (UM) job progression 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 performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs.
Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED) Maternity Alcohol / Drug Autism Spectrum Disorders (ASD) etc.
Primary duties may include but are not limited to: Responds to more complex cases and account specific requests.
Uses appropriate screening criteria knowledge and clinical judgment to assess member needs.
Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment.
Monitors and evaluates effectiveness of care plan and modifies plan as needed.
Supports member access to appropriate quality and cost effective care.
Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers.
Serves as a resource to other BH Case Mgrs.
Participates in cross-functional teams projects and initiatives.
Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 years of clinical experience in social work counseling with broad range of experience with complex 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 LMHC LICSW LPC (as allowed by applicable state laws) LMFT LMSW (as allowed by applicable state laws) or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.
Previous experience in case management and telephonic and/or in person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders.
Managed care experience required.
For Government business only LAPC LAMFT (as allowed by applicable state laws) is also acceptable in addition to other licensure referenced above; and any other state or federal requirements that may apply.
Experience in health coaching and motivational interviewing techniques preferred.
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 firstname.lastname@example.org for assistance.