Anthem In. Case Management Jobs

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Anthem, Inc Behavioral Health Care Manager II (Western U.S.A.) PS20328 in Smithfield, Rhode Island

Behavioral Health Care Manager II (Western U.S.A.) PS20328

Location: United States

Requisition #: PS20328

Post Date: Aug 12, 2019

YourTalent. 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 healthcare .

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.

BehavioralHealth Care Manager I/II

Position will be filled at level ofexperience of candidate selected.

WorkLocation – Western United States: Open to work from home, or any Anthem Office

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 appropriatescreening criteria knowledge and clinical judgment to assess member needsto ensure access to medically necessary quality behavioral healthcare in acost effective setting in accordance with UM Clinical Guidelines andcontract.

  • Refers cases toPeer Reviewers as appropriate.

  • Performspsychiatric and substance abuse or substance abuse disorder assessmentcoordination implementation case planning monitoring and evaluating topromote quality member outcomes to optimize member health benefits and topromote effective use of health benefits and community resources.

  • Will serve as aresource to other BH Care Managers.

  • Assists withmore complex cases and may participate in inter and intradepartmentalteams projects and initiatives.

Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing; 3-4 years of experience with facility-based and/or outpatient 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 as an RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT 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/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required. Prior managed care experience required. Experience working with Microsoft Office (Outlook, Word, and Excel). Experience working with electronic databases, multiple PC’s, data entry, and typing. For URAC accredited areas the following applies: 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 byFortune magazine and is a 2018 DiversityInc magazine Top 50 Company forDiversity. To learn more about our company and apply, please visit us atcareers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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