Behavioral Health Care Manager II
4 weeks ago
Elevance Health is seeking a highly skilled Behavioral Health Care Manager II to join our team. As a key member of our team, you will be responsible for managing psychiatric disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.
Key Responsibilities- 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 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.
- MA/MS in social work, counseling, or a 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.
- Current active unrestricted license such as LCSW, LMSW, LMHC, LPC, LBA (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.
- Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases.
- Prior managed care experience.
- For states that do not require licensure, a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.
- For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.
Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution. The salary range for this position is $66,948 to $83,685, and the location is New York.
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