Behavioral Health Care Manager Job Family I or II PS19879

Behavioral Health Care Manager Job Family I or II PS19879Location: United StatesNewField: MedicalRequisition #: PS19879Your 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.Please Note: This position may be filled at either the Behavioral Health Care Manager I or II. Manager will determine level based upon the selected applicant’s skillset relative to the qualifications listed for this position."Behavioral Care Manager IResponsible 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 and medical necessity criteria for behavioral health inpatient and outpatient levels of careDemonstrates 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.Behavioral Health Care Manager IIResponsible 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 and medical necessity criteria for behavioral health inpatient and outpatient levels of care.Demonstrates 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.Will serve as a resource to other BH Care Managers.Assists with more complex cases, and may participate in inter and intradepartmental teams, projects and initiatives.Locations for this position9133 W. Russell Road, Las Vegas NV, 89148 ( Work from home is an option in NV location, may have to travel to Norfolk VA for training)5800 Northhampton Blvd, Norfolk VA 23502 (Norfolk location is required to work in office)HoursThe department is open Monday - Friday 8AM to 8 PM EST you must be able to work any shift during those hours.Behavioral Care Manager IRequiresMS or MA in social work, counseling, nursing or a related behavioral health field;3 years’ 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 a RN, LCSW, LPC, LMFT, MFT to practice as a health professional within the scope of licensure in state of VA or NVExperience working with Microsoft Office (Outlook, Word, and Excel)Experience working with electronic databases, multiple PC’s, data entry, and typingPrevious experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.Experience using Facets and Macess is preferredBehavioral Care Manager IIRequiresMS or MA in social work, counseling, nursing or a related behavioral health field;3-4 years’ 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 a RN, LCSW, LPC, LMFT, or MFT to practice as a health professional within the scope of licensure in VA or NVExperience working with Microsoft Office (Outlook, Word, and Excel)Experience working with electronic databases, multiple PC’s, data entry, and typingPrevious experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.Prior managed care experience requiredExperience using Facets and Macess is 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.