Elevance Health
This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. The
Behavior Health Care Manager II
will be responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. How You Will Make An Impact 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. 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. Minimum Requirements Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 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 required. Prior managed care experience required. Current active unrestricted license in the state of Georgia such as RN LCSW LPC (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required licensure is a requirement for this position. Preferred Skills, Capabilities, And Experiences Two additional years with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment is highly preferred. If RN- prefer experience in crisis stabilization or acute inpatient psychiatric units. Work within or knowledge of GA DBHDD (Department of Behavioral Health and Developmental Disabilities) provider network is strongly preferred. 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 (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
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Behavior Health Care Manager II
will be responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. How You Will Make An Impact 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. 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. Minimum Requirements Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 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 required. Prior managed care experience required. Current active unrestricted license in the state of Georgia such as RN LCSW LPC (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required licensure is a requirement for this position. Preferred Skills, Capabilities, And Experiences Two additional years with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment is highly preferred. If RN- prefer experience in crisis stabilization or acute inpatient psychiatric units. Work within or knowledge of GA DBHDD (Department of Behavioral Health and Developmental Disabilities) provider network is strongly preferred. 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 (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.
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