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Anthem BH Care Manager I or II - Remote in CA PS24800 in West Covina, California

BH Care Manager I or II - Remote in CA PS24800

Location: California, United States

New

Requisition #: PS24800

Post Date: 1 day ago

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.

BH Care Manager I or II Job Family

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

Responsible for managing facility-based care with some Psychiatric and Substance Abuse facility-based and outpatient benefits through telephonic or written review. Facility based care includes Acute Inpatient, Detox, Residential, Partial Hospitalization and Intensive Outpatient levels of care.

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 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.(II)

•Assists with more complex cases, and may participate in inter and intradepartmental teams, projects and initiatives.(II)

•This Care manger job requires the candidate to be able to type very fast while they talk to 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.

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

BH Care Manager I or II

•Requires MS or MA in social work, counseling, or a related behavioral health field or a degree in nursing and 3 years experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment

oOr any combination of education and experience, which would provide an equivalent background.

•Current unrestricted license from the State of California as an LCSW, LMFT, RN, or Clinical Psychologist required.

•Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases

•Experience on multiple levels with computers

•Strong clinical background in eating disorders and all levels of care with eating disorder treatment

•2-3 years of clinical experience

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

•Must live within 60 miles of an Anthem office and be located in California

•Prior managed care experience

*May be hired as a Behavioral Health Care Manager Level l, or Level ll depending upon 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 is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.

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