Behavioral Health Services Manager II
6 days ago
About the Role:
The Manager II Behavioral Health Services will be responsible for leading a team of licensed clinicians and non-clinical support staff in the utilization management and case management of behavioral health services. This role will involve ensuring the appropriate utilization of behavioral health services, managing consultation with facilities and providers, and developing and maintaining positive relationships with providers and members.
Key Responsibilities:
- Manage a team of licensed clinicians and non-clinical support staff responsible for ensuring medical necessity and appropriateness of care for inpatient/outpatient behavioral health services.
- Ensure appropriate utilization of behavioral health services through level of care determination, accurate interpretation/application of benefits, corporate medical policy, and cost-efficient, high-quality care.
- Manage consultation with facilities and providers to discuss plan benefits and alternative services.
- Manage case consultation and education to customers and internal staff for efficient utilization of behavioral health services.
- Develop and maintain positive relationships with providers and work to ensure quality outcomes and cost-effective care.
- Assist in developing clinical guidelines and medical policies used in performing medical necessity reviews.
- Provide leadership in the development of new pilots and initiatives to improve care or lower the cost of care.
Requirements:
- Current, active, unrestricted license such as RN, LCSW, LMHC, LPC, LBA, LMFT, LMSW, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States.
- Prior experience in a managed care setting required.
- MS in social work, counseling, psychology, or related behavioral health field or a degree in nursing and minimum of 5 years of clinical experience with facility-based and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience, which includes a minimum of 2 years prior management experience.
Preferred Skills, Capabilities, and Experiences:
- Experience applying clinical and policy knowledge on the continuum of behavioral health treatment strongly preferred.
- Certification as a Case Manager preferred.
About Elevance Health:
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
Our Culture:
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources, to name a few.
Hybrid Workforce Strategy:
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times 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.
Equal Employment Opportunity:
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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