Licensed Behavioral Health, BH Care Manager I or II (Utilization Management) - Remote - Virginia - P

Licensed Behavioral Health, BH Care Manager I or II (Utilization Management) - Remote - Virginia - PS4742
Location: Virginia, United States
Field: Medical
Requisition #: PS4742
Post Date: Apr 13, 2018
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.
This BH Care Manager position focuses on utilization management of community mental health rehabilitation services. It is based in the Richmond, VA office, however, we can consider anyone living in and licensed in the state of Virginia. You can work in the Richmond office or you can be given the equipment needed for a home office. You must have a high speed internet connection.
The BH Care Manager is 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.
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.
May 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.
This BH Care Manager position may be hired as a level I or level II depending upon the background, skills and experience of the chosen candidate.
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 LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in Virginia 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 preferred.
-Experience working with community health rehab services preferred.
-Computer skills: MS Office (Word, Outlook, Excel) You must be comfortable working on a computer with web-based applications.
Anthem, Inc. is ranked as one of America?s Most Admired Companies among health insurers by Fortune magazine and is a 2017 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.

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