Elevance Health
Behavioral Health Care Manager I
Locations:
The selected candidate must reside within a reasonable commuting distance of the designated posting location(s): Virginia, Indiana, Georgia, Ohio, Florida, District of Columbia (Washington, DC); Maryland; New Jersey, New York, and Texas.
This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. Alternate locations may be considered if candidates reside within commuting distance from an office.
Please note that per our 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.
The
Behavioral Health Care Manager I
is 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, optimize member health benefits, and promote effective use of health benefits and community resources.
Minimum Requirements
Requires MA/MS in social work counseling or related behavioral health field or a degree in nursing, and a 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 that provides an equivalent background.
Current active unrestricted license (e.g., RN, LCSW, LMSW, LMHC, LPC, LBA, LMFT or Clinical Psychologist) required to practice as a health professional within the scope of licensure in applicable states or territories. Licensure is required for this position.
For states that do not require licensure, a Board Certified Behavioral Analyst (BCBA) is acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for ABA services only, and there is licensed staff supervision.
Previous experience in case management/utilization management with a broad range of complex psychiatric/substance abuse cases preferred.
Preferred Skills, Capabilities and Experiences
Experience in behavioral health utilization management is highly preferred.
Exceptional at multitasking in a fast-paced environment.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams).
Strong typing accuracy skills.
Good communication and organization skills.
Salary The salary range for this position is $62,640 to $112,752, depending on location, experience, education, and skill level.
Benefits Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).
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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
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The selected candidate must reside within a reasonable commuting distance of the designated posting location(s): Virginia, Indiana, Georgia, Ohio, Florida, District of Columbia (Washington, DC); Maryland; New Jersey, New York, and Texas.
This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. Alternate locations may be considered if candidates reside within commuting distance from an office.
Please note that per our 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.
The
Behavioral Health Care Manager I
is 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, optimize member health benefits, and promote effective use of health benefits and community resources.
Minimum Requirements
Requires MA/MS in social work counseling or related behavioral health field or a degree in nursing, and a 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 that provides an equivalent background.
Current active unrestricted license (e.g., RN, LCSW, LMSW, LMHC, LPC, LBA, LMFT or Clinical Psychologist) required to practice as a health professional within the scope of licensure in applicable states or territories. Licensure is required for this position.
For states that do not require licensure, a Board Certified Behavioral Analyst (BCBA) is acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for ABA services only, and there is licensed staff supervision.
Previous experience in case management/utilization management with a broad range of complex psychiatric/substance abuse cases preferred.
Preferred Skills, Capabilities and Experiences
Experience in behavioral health utilization management is highly preferred.
Exceptional at multitasking in a fast-paced environment.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook, Teams).
Strong typing accuracy skills.
Good communication and organization skills.
Salary The salary range for this position is $62,640 to $112,752, depending on location, experience, education, and skill level.
Benefits Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).
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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
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