Behavioral Health Care Manager I

🕒 September 10

🌲 North Carolina, Ohio – Remote

🌲 North Carolina – Remote 🏈 Ohio – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 44%

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Elevance Health

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 B2B

Healthcare • Healthcare Insurance • B2B

Elevance Health is transforming from a traditional health benefits organization into a lifetime trusted health partner, driven by a bold purpose to improve the health of humanity. With nearly 100,000 associates, they serve over 118 million people and utilize an integrated whole health approach supported by industry-leading capabilities and a digital health platform. Their mission includes redefining health, reimagining the health system, and strengthening communities.

📋 Description

• Manage psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review • Use screening criteria knowledge and clinical judgment to assess member needs and ensure access to medically necessary, quality behavioral healthcare in a cost-effective setting • Apply UM Clinical Guidelines and contract requirements • Refer cases to Peer Reviewers as appropriate • Perform psychiatric and substance abuse or substance abuse disorder assessment coordination, implementation, case planning, monitoring, and evaluation • Promote quality member outcomes and optimize member health benefits • Promote effective use of health benefits and community resources • Work virtually full-time, with required in-person training sessions

🎯 Requirements

• MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or equivalent combination of education and experience • Current active unrestricted license, such as RN, LCSW, LMSW, LMHC, LPC, LBA, LMFT, or Clinical Psychologist, to practice as a health professional within the scope of licensure in applicable states or territory of the United States • Licensure is required for this position • A Board Certified Behavioral Analyst (BCBA) is acceptable in qualifying non-licensure states if the role performs UM approvals only, reviews ABA service requests only, and has licensed staff supervision • Crisis call center experience is preferred • Licensed in Ohio is highly preferred • Bilingual in Spanish is preferred • Licensed to practice independently is highly preferred • Previous case management/utilization management experience with complex psychiatric/substance abuse cases is preferred • Strong oral, written, and interpersonal communication skills • Problem-solving skills • Facilitation skills • Analytical skills • Ability to work Monday–Friday, 11 AM–8 PM, covering holidays • For applicable patient/member-facing roles, vaccination against COVID-19 and Influenza is required unless an acceptable explanation is provided

🏖️ Benefits

• Merit increases • Paid holidays • Paid Time Off • Incentive bonus programs • Medical benefits • Dental benefits • Vision benefits • Short-term disability benefits • Long-term disability benefits • 401(k) match • Stock purchase plan • Life insurance • Wellness programs • Financial education resources • Virtual work full-time, except for required in-person training sessions • Accommodation for applicants as required by law