Autism Team - BH Care Manager I or II - California

Description SHIFT: Day JobSCHEDULE: Full-timeYour 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 care companies and a Fortune Top 50 Company.We are seeking a dynamic clinician to serve as a Care Manager on our Autism Spectrum Disorder Program Team who will be responsible for managing Applied Behavior Analysis treatment for Medicaid members with an Autism Spectrum Disorder through telephonic and/or written review.BH Care Manager Job Family I or IIPlease Note: This position may be filled at either the BH Care Mgr I or II level. Manager will determine level based upon the selected applicant’s skillset relative to the qualifications listed for this position.Location: California. Telecommute is an option for internal and external candidates that are currently licensed in CA.Work schedule: 8 hour shift between 8:00am - 6:00pm in your respective time zone. 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; Follows guidelines to refer cases to Medical Advisors as appropriate. Participates in clinical rounds and case presentations with Medical Advisors and clinical teammates when cases fall outside guidelines; Utilizes skills and knowledge in Behavioral Health to appropriately apply clinical guidelines to requests for ABA therapy. Serves as a subject matter expert to other internal stakeholders and participates in multi-disciplinary teams to achieve optimum outcomes across multiple treatment modalities; Maintains confidentiality, ethical and professional standards; Maintains departmental quality and performance standards; Performs other duties as assigned. Will serve as a resource to other BH Care Managers. (Level II) Assists with more complex cases and will participate in inter and intradepartmental teams projects and initiatives.(Level II) Qualifications Requirements: Requires Master’s degree in social work, counseling, nursing or a related behavioral health field; 3+ years experience with facility-based and/or outpatient psychiatric treatment; or any combination of education and experience, which would provide an equivalent background. Current CA (California) active unrestricted license as an RN, LCSW, LISW, 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 California. Previous experience in case management/utilization management. Behavioral health license combined with BCBA certification preferred. Managed care industry experience. Knowledge and understanding of Applied Behavior Analytics techniques preferred Experience with Autism Spectrum Disorder is preferredAnthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.REQNUMBER: PS37875