[Hiring] Behavioral Health Care Manager II - Utilization Management @Elevance Health

Role Description

The Behavioral Health Care Manager II - Utilization Management is responsible for managing psychiatric and substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.

• 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 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.

Qualifications

• MA/MS in social work, counseling, or a related behavioral health field.
• Minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse disorder treatment.
• Current, active, unrestricted license such as LCSW, LMSW, LMHC, LPC, LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable state(s) 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.
• Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Requirements

• California licensed clinician is highly preferred.

Benefits

• Comprehensive benefits package.
• Incentive and recognition programs.
• Equity stock purchase and 401k contribution (subject to eligibility requirements).
• Merit increases, paid holidays, and Paid Time Off.
• Medical, dental, vision, short and long-term disability benefits.
• Life insurance, wellness programs, and financial education resources.