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Behavioral Health Care Manager Lead - PS28860Location: California, United StatesNewRequisition #: PS28860Your Talent. Our Vision. At Anthem Blue Cross , a proud member of the Anthem, Inc. family of companies, 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.Location: Must reside in California. Remote opportunity. Preference given to candidates residing in Southern California.The Behavioral Health Care Manager Lead is responsible for coordinating workflows for care 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 resources 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.
Requires MS or MA in social work counseling or related behavioral health field or a degree in nursing; 5+ 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. For URAC accredited areas the following applies: Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. Experience with Applied Behavioral Analysis strongly preferred.Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
Vacancy expired!