Anthem In. Case Management Jobs

Job Information

Anthem, Inc. Behavioral Health Care Manager II in Norfolk, Virginia

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 benefits companies and a Fortune Top 50 Company.

The Behavioral Health Care Manager I/II (Utilization Management) 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.

You are responsible for managing psychiatric or substance abuse community-based and facility-based behavioral health benefits through telephonic or written review.

This position may be filled as BH Care Manager I or II - the level will be determined based on the candidate's experience and background

Location: This is a remote from home position. Must be licensed in Virginia.

Primary duties may include, but are not limited to:

  • Uses appropriate screening and medical necessity criteria for behavioral health urgent levels of care to ensure access to medically necessary quality behavioral healthcare in a cost effective setting.

  • Demonstrates knowledge and clinical judgment to assess member needs in accordance with UM Clinical Guidelines and contracts.

  • Refers cases to Peer Reviewers as appropriate.

  • Participates in care coordination, implementation, case discharge planning, and monitoring to promote quality member outcomes, to optimize member health benefits, and to promote effective use of health benefits and community resources.

Qualifications

Minimum Requirements:

  • Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing

  • Current active unrestricted license as an LCSW, LPC, LMFT, or RN from the state of Virginia required.

  • 3 years of experience with facility-based and/or out patient psychiatrics and substance or substance abuse disorder treatment and/or any combination of education and experience which would provide an equivalent background.

  • Must be proficient in Microsoft Office products.

    Preferred Qualifications:

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

  • Basic analytical, communication and vocational skills and ability to operate systems preferred.

  • Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills 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. 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. 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: PS60160

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