Elevance Health
Overview
Anticipated End Date:
2025-10-03
Position Title:
Carelon Behavioral Health Case Manager II
Job Description:
Carelon Behavioral Health Case Manager II
Location:
This role enables associates to work virtually, with the exception of required in-person group sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face requirements.
Travel and in-person requirements:
This role will be required to go to Worcester, MA and surrounding areas detox centers to run group meetings 3 or more days a week. Please note that per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
Role Focus The BH Case Manager II role involves complete clinical assessment and is primarily member facing. The BH Case Manager (CM) role progresses with a primary focus on members, while the BH Care Manager (UM) is primarily provider facing with some member-facing activities such as information collection and ensuring appropriate levels of care.
Responsible for performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance use needs. Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED), Maternity, Alcohol / Drug issues, Autism Spectrum Disorders (ASD), etc.
How you will make an impact:
Run SUD TOC Groups (Substance Use Disorder Transition of Care) three times a week at Worcester area detoxes.
Support members discharging from detox accessing treatment.
Complete Utilization Management for inpatient and outpatient level of care.
Respond to more complex cases and account-specific requests.
Use screening criteria knowledge and clinical judgment to assess member needs.
Conduct assessments to identify individual needs and develop specific care plans.
Monitor and evaluate effectiveness of care plans and modify as needed.
Support member access to appropriate quality and cost-effective care.
Coordinate with internal and external resources and collaborate with providers.
Serve as a resource to other BH Case Managers.
Participate in cross-functional teams, projects, and initiatives.
Minimum Requirements:
Requires MA/MS in social work, counseling or related behavioral health field or a degree in nursing, and minimum of 3 years of clinical experience in social work/counseling with broad experience with complex psychiatric and substance use treatment; or any combination of education and experience that provides an equivalent background.
Current active unrestricted license such as RN, LCSW, LMHC, LICSW, LPC (as allowed by applicable state laws); LMFT, LMSW (as allowed by applicable state laws) or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states; required.
Managed care experience required.
Preferred Skills, Capabilities, and Experiences:
Previous experience in case management and telephonic and/or in-person coaching with members with complex psychiatric/substance use and/or medical disorders.
Substance use and detox experience desired.
For Government business only LAPC LAMFT (as allowed by applicable state laws) is acceptable in addition to other licensure; health coaching and motivational interviewing techniques preferred.
For associates working within Puerto Rico who are member-facing, current PR health certificate and PR Law 300 certificate are required.
Job Details Job Level:
Non-Management Exempt
Workshift:
1st Shift (United States of America)
Job Family:
MED > Licensed/Certified Behavioral Health Role
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status protected by applicable law. Applicants who require accommodation to participate in the job application process may contact e relevance health job support at example.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including the California Fair Chance Act.
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2025-10-03
Position Title:
Carelon Behavioral Health Case Manager II
Job Description:
Carelon Behavioral Health Case Manager II
Location:
This role enables associates to work virtually, with the exception of required in-person group sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face requirements.
Travel and in-person requirements:
This role will be required to go to Worcester, MA and surrounding areas detox centers to run group meetings 3 or more days a week. Please note that per policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.
A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
Role Focus The BH Case Manager II role involves complete clinical assessment and is primarily member facing. The BH Case Manager (CM) role progresses with a primary focus on members, while the BH Care Manager (UM) is primarily provider facing with some member-facing activities such as information collection and ensuring appropriate levels of care.
Responsible for performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance use needs. Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED), Maternity, Alcohol / Drug issues, Autism Spectrum Disorders (ASD), etc.
How you will make an impact:
Run SUD TOC Groups (Substance Use Disorder Transition of Care) three times a week at Worcester area detoxes.
Support members discharging from detox accessing treatment.
Complete Utilization Management for inpatient and outpatient level of care.
Respond to more complex cases and account-specific requests.
Use screening criteria knowledge and clinical judgment to assess member needs.
Conduct assessments to identify individual needs and develop specific care plans.
Monitor and evaluate effectiveness of care plans and modify as needed.
Support member access to appropriate quality and cost-effective care.
Coordinate with internal and external resources and collaborate with providers.
Serve as a resource to other BH Case Managers.
Participate in cross-functional teams, projects, and initiatives.
Minimum Requirements:
Requires MA/MS in social work, counseling or related behavioral health field or a degree in nursing, and minimum of 3 years of clinical experience in social work/counseling with broad experience with complex psychiatric and substance use treatment; or any combination of education and experience that provides an equivalent background.
Current active unrestricted license such as RN, LCSW, LMHC, LICSW, LPC (as allowed by applicable state laws); LMFT, LMSW (as allowed by applicable state laws) or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states; required.
Managed care experience required.
Preferred Skills, Capabilities, and Experiences:
Previous experience in case management and telephonic and/or in-person coaching with members with complex psychiatric/substance use and/or medical disorders.
Substance use and detox experience desired.
For Government business only LAPC LAMFT (as allowed by applicable state laws) is acceptable in addition to other licensure; health coaching and motivational interviewing techniques preferred.
For associates working within Puerto Rico who are member-facing, current PR health certificate and PR Law 300 certificate are required.
Job Details Job Level:
Non-Management Exempt
Workshift:
1st Shift (United States of America)
Job Family:
MED > Licensed/Certified Behavioral Health Role
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender, marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status protected by applicable law. Applicants who require accommodation to participate in the job application process may contact e relevance health job support at example.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including the California Fair Chance Act.
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