Behavioral Health Care Manager I

🔥 0 minutes ago

🌲 North Carolina, Ohio – Remote

🌲 North Carolina – Remote 🏈 Ohio – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👔 Manager

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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 • Ensure access to medically necessary, quality behavioral healthcare in a cost-effective setting according to UM Clinical Guidelines and contract • 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

🎯 Requirements

• MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing • Minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment • 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 • BCBA is acceptable in states that do not require licensure only if the associate performs UM approvals only, reviews ABA service requests only, and has licensed staff supervision • Crisis call center experience preferred • Ohio licensure highly preferred • Bilingual Spanish preferred • Independent practice license highly preferred • Previous case management/utilization management experience with complex psychiatric/substance abuse cases preferred • Strong oral, written, and interpersonal communication skills • Problem-solving skills • Facilitation skills • Analytical skills • Ability to work Monday–Friday, 11AM–8PM, including holidays

🏖️ 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 flexibility, except for required in-person training sessions