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Behavioral Health Care Manager, Inpatient UM - Virginia (remote) PS16414

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PS16414 Requisition #
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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.


Location:   This is a remote from home position based anywhere in the state.  Full-time Virginia residency is required.

The BH Care Manager (Utilization Management) is primarily a provider facing role, although it does 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.  You are 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 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.
  • Optimize member health benefits and to promote effective use of health benefits and community resources.
  • Virginia residency required.
  • Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing
  • Current active unrestricted license as an LCSW, LPC, LMFT, or RN from the state of Virginia required.
  • 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment.
  • Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
  • Previous experience in rehabilitation services preferred.
  • Must be proficient in Microsoft Office products.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2015 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at antheminc.com/careers.
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Your education. Our inspiration.

This is a brilliant combination. This is where people united with passion and a purpose can make a huge impact. This is Anthem, where innovation is the force that will drive the future of health care.

So what drives you? If it’s the desire to build a career where the work you affects millions, you’re in the right place. Take what you’ve learned to the next level, combine your knowledge with our experience, expertise and resources; and start changing peoples’ lives.

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Ready to build a career where you make a difference and impact millions of lives? Review our undergraduate and graduate internship programs where you can combine your knowledge, experience and expertise in a growing industry.

Build your career, or even start it through our undergraduate and graduate internships that help us identify future leaders. We’re transforming our industry and here’s the chance to be a part of it.

 

MBA Program

What drives you? For MBA candidates our leadership development program is an opportunity to apply your academic and professional experience in pursuit of a rewarding and challenging career with one of Fortune magazine’s most admired companies.

Anthem is transforming healthcare for millions as one of the nation’s leading health benefit companies. We are working to not just navigate the changes in the health care market but lead. By leading we can build on our commitment to make a lasting, positive difference for our consumers, care providers, and communities.

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Your Questions, Answered

You have to be at least 18 years of age (unless part of an approved/sponsored program) and currently enrolled in an accredited US college or university. For actuarial students, sitting for or having at least one exam completed by the time your interview is an advantage.

Visit our main page and search internships – apply via APPLY link on the specific opportunity.

We offer internships that are 3 months, 6 months and part-time during the school year. Our opportunities are based on business needs and student availability.

We are delighted to get to know you! Our team participates in various on-campus events throughout the year and from time to time hosts meetings in our offices. The fastest way to see where you stand in the application process is to log into our system to check your status.

Because internships are temporary positions, the only benefits offered at this time are access to our onsite fitness facilities, and the ability to contribute to a 401k. We do, however, offer opportunities to get connected, and be mentored through our various ARGs (Associate Resource Groups).