Anthem, Inc. BH Care Manager I or II (Work hours are PST) in Las Vegas, Nevada
SHIFT: Day Job
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 care companies and a Fortune Top 50 Company.
Behavioral Health Care Manager I/II Work Location – Western United States: Open to work from home, or any Anthem Office Hours are Monday- Friday 8 am-5 pm PST
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 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.
• Requires a Master’s degree in social work, counseling, or a degree in nursing • Requires 3 years of clinical experience providing treatment to individuals with complex psychiatric and or substance use disorder diagnosis in an inpatient or outpatient setting • Requires Current active unrestricted license to practice as an RN LCSW LPC LMFT or Clinical Psychologist within the scope of licensure in the state you reside in • Requires experience working on multiple computer platforms simultaneously • Requires excellent typing skills • Preferred experience in utilization management • Preferred experience in managed care
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
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