BH Care Manager II

4 weeks ago

Cincinnati, Ohio, United States Elevance Health Full time
Job Summary

We are seeking a highly skilled BH Care Manager II to join our team at Elevance Health. As a key member of our organization, 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.
Requirements
  • 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.
  • 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 required.
  • 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.
  • However, 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.
What We Offer

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. We operate in a Hybrid Workforce Strategy, and associates are required to work at an Elevance Health location at least once per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

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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