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.
Title:BH Care Manager I/II/III
Location:Any Anthem office (CA preferred).Candidates have to be located within driving distance from an Anthem office.
Work schedule:8 hour shift between 8:00am - 6:00pm of the appropriate time zone.
Please note: 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. Whereas the BH Case Mgr (CM) job progression is primarily member facing and involves complete clinical assessment.
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 appropriate screening criteria, 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.
Provides telephonic Utilization Management (UM) reviews related to Applied Behavior Analysis (ABA). Specific knowledge related to Autism Spectrum Disorders and the treatment modality of ABA is required.
Follows guidelines to refer cases to Medical Advisors as appropriate.
Utilizes skills and knowledge in psychiatric and behavior analytic assessment, negotiation, coordination, implementation, case planning, resource acquisitions, monitoring and evaluating to promote quality member outcomes.
Refers cases to Peer Reviewers as appropriate.
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.
Requires MS 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 an LCSW, LPC, LMHC, LMFT, RN, or Clinical Psychologist, to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.
Experience with Autism Spectrum Disorder is highly preferred.
LBA (as allowed by applicable state laws) is preferred.
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.
May be hired as a Behavioral Health Care Manager l,ll or lll depending upon level of education, skills, and relevant experience.
/ Anthem, Inc. is ranked as one of America?s Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran. /
Title: BH Care Manager I,ll,lll - LCSW, LPC, LMFT, LMHC, RN -Any Anthem Office (CA Preferred) - 123008
Other Locations: California
Requisition ID: 123008 1dbfaa364ed74dcbabea1f690314b87f
We recently changed our name from WellPoint to Anthem, Inc., the name people know us by best. As our companies continue to take a more active role in helping people access the right health care and programs, going by a name that people know and trust is important.
Anthem, Inc. is one of the nation's leading health benefits insurer and a Fortune Top 50 company. At Anthem, Inc., we are working to transform health care with trusted and caring solutions and meaningfully advance affordability and better health outcomes for our health plan members. Nearly 69 million people are served by our affiliated companies including more than 37 million enrolled in our family of health plans.
- One in nine Americans receives coverage for their medical care through Anthem's affiliated plans.
- We offer a broad range of medical and specialty products.
Bring your expertise to our innovative, achievement-driven culture, and you will discover lasting rewards and the opportunity to help drive the future of health care.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our co