25 Dec
BH Care Manager I or II
California, Anaheim , 92801 Anaheim USA

Vacancy expired!

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.BH Care Manager I or II Job Family

May be hired as a Behavioral Health Care Manager Level l, or Level ll depending upon the level of education, skills, and relevant experience.

Preferred Location: St. Louis, Missouri

Open to other major Anthem office locations

Candidates must reside within commuting distance to an Anthem office and be willing to work from an Anthem office in the future, if required.Responsible for managing Psychiatric and Substance Abuse facility-based treatment through telephonic, written, or faxed review. Facility-based care includes Acute Inpatient, Detox, Residential, Partial Hospitalization, TMS and Intensive Outpatient levels of carePrimary 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 the least restrictive setting following UM Clinical Guidelines and contract.

Refers cases to Peer Reviewers as appropriate.

Performs facility-based, psychiatric and substance abuse initial reviews and assessment of care, and continued stay reviews to ensure coordination, of care, case planning, monitoring, and evaluating facility-based care 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 complex cases, and may participate in inter and intradepartmental teams, projects, and initiatives.

This Care manager job requires the candidate to be able to type very fast while they talk to the Utilization Review staff person on the phone and receiving from them specific details about how a member (patient) is doing.

Review information is either provided on the phone live or from their voicemail, or received by fax

Ability to work on multiple computer platforms simultaneously to manage caseload in addition to excellent typing skills

Must participate in twice weekly staffing with Medical DirectorsQualifications BH Care Manager I or II Requires a Master’s degree in social work, counseling, or a degree in nursing

Requires 3 years of clinical experience providing treatment to individuals with complex psychiatric and or substance use disorder diagnosis

Requires Current active unrestricted clinical license to practice as an RN LCSW LPC LMFT or Clinical Psychologist within the scope of licensure in your resident State

Requires experience working on multiple computer platforms simultaneouslyRequires excellent typing skills

Preferred experience in case management or utilization management

Preferred experience in managed careMay be hired as a Behavioral Health Care Manager Level l, or Level ll depending upon the 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 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. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.REQNUMBER: PS43104-US

Vacancy expired!


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