Job Details

Behavioral Health Care Manager I or II (Intake) -Norfolk VA (132629 KT)

Medical
VA-Norfolk
September 14, 2017

Description

Anthem, Inc. is one of the nation’s leading health benefits companies and a Fortune Top 50 company. At Anthem, Inc., we are working together to transform health care with trusted and caring solutions.

Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people’s lives, and to take your career further than you can imagine.

Please Note: This position may be filled at either the Behavioral Health Care Manager I, Behavioral Health Care Manager II, or Behavioral Health Care Manager III will determine level based upon the selected applicant’s skillset relative to the qualifications listed for this position.’

Behavioral Care Manager I

Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.

Primary duties may include, but are not limited to:

Uses appropriate screening and medical necessity criteria for behavioral health inpatient and outpatient levels of care

  • Demonstrates 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 psychiatric and substance abuse or substance abuse disorder assessment, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes, to optimize member health benefits, and to promote effective use of health benefits and community resources.

Behavioral Health Care Manager II

Responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.

Primary duties may include, but are not limited to:

  • Uses appropriate screening and medical necessity criteria for behavioral health inpatient and outpatient levels of care.
  • Demonstrates 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 psychiatric and substance abuse or substance abuse disorder assessment, coordination, implementation, case planning, monitoring, and evaluating 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 more complex cases, and may participate in inter and intradepartmental teams, projects and initiatives.

Locations for this position

  • 5800 Northhampton Blvd, Norfolk VA 23502 (This is an on-site position)

Hours

  • The department is open Monday – Friday 8AM to 8 PM EST you must be able to work any shift during those hours.

Qualifications

Behavioral Care Manager I
Requires
  • MS or MA in social work, counseling, nursing or a related behavioral health field;
  • 3 years’ experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.
  • Current active unrestricted license as a RN, LCSW, LPC, LMFT, MFT to practice as a health professional within the scope of licensure in state of VA.
  • Experience working with Microsoft Office (Outlook, Word, and Excel)
  • Experience working with electronic databases, multiple PC’s, data entry, and typing
  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
  • Experience using Facets and Macess is preferred

Behavioral Care Manager II

Requires
  • MS or MA in social work, counseling, nursing or a related behavioral health field;
  • 3-4 years’ experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.
  • Current active unrestricted license as a RN, LCSW, LPC, LMFT, or MFT to practice as a health professional within the scope of licensure in VA.
  • Experience working with Microsoft Office (Outlook, Word, and Excel)
  • Experience working with electronic databases, multiple PC’s, data entry, and typing
  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required.
  • Prior managed care experience required
  • Experience using Facets and Macess is preferred

Anthem is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at www.antheminc.com/careers. EOE.M/F/Disability/Veteran.

*WARNING : Please beware of phishing scams that promote work-at-home opportunities and which may also pose as legitimate companies. Please be advised that an Anthem recruiter will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for a role with our company. All of our careers require that you first complete an online application.