🌎
This job posting isn't available in all website languages

Behavioral Health Care Manager Utilization Management, $1,000 SIGN ON BONUS PS14879

📁
Medical
📅
PS14879 Requisition #
Apply for Job
Recommend to a Friend
Sign Up for Job Alerts
Your Talent. Our Vision. At Anthem, Inc., the Government Business Division is focused on serving Medicaid, Medicare and uninsured individuals. Our commitment and focus on government health programs is the foundation upon which we’re creating better care for our members, greater value for our customers and better health for our communities. Join us and together we will drive the future of health care.
 
Join one of the fastest growing businesses in a company with the largest and most successful Medicaid business in the nation. The associate in this position will be supporting members enrolled in the Minnesota Medicaid Program. 

Behavioral Health Care Manager Utilization Management 
Level I/II/III (Job Family) Eagan, MN PS14879

Work Location: Eagan, Minnesota
This is an office based position - Monday-Friday 8 a.m. - 5 p.m.

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

Please note: The BH Care Manager (UM) job progression is primarily a provider facing role although it may involve some member facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level 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 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.  

Level II:
• 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. 

Level III:
• Will serve as a resource to other BH Care Managers. 
• Assists with more complex cases  and will participate in inter and intradepartmental teams  projects and initiatives. 
• Will serve as an assistant to the BH Care Manager Ld in implementing identified operational processes. 
• Will develop expertise in specified areas of business needs to assist management with unit operations. 
• May act as lead in the lead’s absence. 


Level I:
• Requires MS or MA in social work  counseling or a related behavioral health field or a degree in nursing; 
• 3 years of 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. 
• Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.

Level II:
• Requires MS or MA in social work  counseling  or a related behavioral health field or a degree in nursing; 
• 3-4 years of 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. 
• 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.

Level III:
• Requires MS or MA in social work  counseling or a related behavioral health field or a degree in nursing; 
• 4-5 years of 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. 
• 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.

Key Qualifications:
• Utilization Management Experience
• Experience working with Children/Adolescents and Adults.
• Managed Care experience.
• Community Mental Health experience; knowledge of state resources.

Licensure Requirements:
• Current active unrestricted license as an RN, LCSW,  LMSW,  LMHC,  LPC,  LBA (as allowed by applicable state laws),  LMFT,  or Clinical Psychologist  to practice as a health professional within the scope of licensure in the state of Minnesota required. 
• In addition to the above list, Approved Clinical Licensure specific to Minnesota:
LISW, LICSW, LPCC, and Licensed Psychologist. 


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

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.



Previous Job Searches

Activity Feed

26080
Job shares through Anthem, Inc.
Someone applied to the Business Analyst III - Medicare/Medicaid (PS8217) position. Less than a minute ago
Someone applied to the Account Management Executive Consultant - Northern California - PS15596 position. Less than a minute ago
Someone applied to the HR Business Partner or Sr. - Job Family - TN, MN, IN, or GA (PS15783KT) position. Less than a minute ago
Someone applied to the Customer Care Representatives - Miami, FL - 0140793 position. Less than a minute ago
Someone applied to the Nurse Medical Mgmt II / I - PS 16584 - Any No/So East locations or No/So East Remote position. Less than a minute ago

Life At Anthem

There’s something truly unique going on within Anthem. Everywhere you look, you’ll find smart, passionate people looking for ways to drive the future of health care by making a positive impact.

So what drives us? We’re guided by a powerful set of Values – shared priorities that influence our every interaction with each other, our customers and our community.

We encourage associates to be Innovative, Trustworthy and socially responsible.

We’re committed to being Easy-to-Do Business With; striving always to make things easier for customers.

We work together, with each other and with the people we serve, and we make a real difference by Caring, treating our customers the way we want to be treated.

We demand Accountability, and we take joy in recognizing those who lead by example – at work, and in the community.

We treat others the way we want to be treated, and it makes all the difference. If you’re looking for an opportunity to work with a forward-thinking industry leader, there’s not better place to find yourself than here!

Anthem’s Standards of Ethical Business Conduct (Code of Conduct) guides our actions and supports our values.