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Description SHIFT: Day JobSCHEDULE: Full-timeYour 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 Work hours: M-F 8-5 PSTWork Location – Western United States: Open to work from home, or an Anthem OfficeResponsible 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.Qualifications Requires MS or MA in social work counseling or a related behavioral health field or a degree in nursing; 3-4 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 as an RN LCSW 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. Experience working with Microsoft Office (Outlook, Word, and Excel). Experience working with electronic databases, multiple PC’s, data entry, and typing. Requires strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.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.REQNUMBER: PS37524-US
