BH Case Manager I/II

<p class="readOnlyFrame">Your Talent. Our Vision.&nbsp;<strong>At Anthem, Inc</strong>., it&rsquo;s a powerful combination, and the foundation upon which we&rsquo;re creating greater care for our members, greater value for our customers, and greater health for our communities. Join us and together we will&nbsp;<strong>drive the future of health care</strong>.</p> <p class="readOnlyFrame" align="left">&nbsp;</p>

California or Colorado

Anthem, Inc. - Behavioral Health

Anthem is working to transform health care with trusted and caring solutions. Our health plan companies deliver quality products and services that give their members access to the care they need. With over 74 million people served by its affiliated companies, including approximately 40 million within its family of health plans, Anthem is one of the nation's leading health benefits companies.

keywords: management,assessment,analysis,teamwork,management,quality assurance,experience,license,degree


Overview: <p style="font-weight: 400;"><strong><u>Location:</u>&nbsp;Any Anthem office (CA/CO preferred).Candidates have to be located within driving distance from an Anthem office.</strong></p> <p style="font-weight: 400;"><strong><u>Work schedule:</u>&nbsp;Work schedule for 8 hours Mon-Friday between 9-6pm; overall a later work schedule (until 6 pm PST) for at least 3 days per week is preferred.</strong></p> <p style="font-weight: 400;"><strong>**This position can be hired at either the BH Case Manager I or BH Case Manager II level**</strong></p> <p style="font-weight: 400;">Please note: The BH Case Mgr (CM) job progression is primarily member facing and involves complete clinical assessment. Whereas the BH Care Manager (UM) job progression is primarily a provider facing role although it does involve some member facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care.</p>
Responsibilities: <p class="readOnlyFrame">Responsible for performing telephonic case management within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs. Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED), Maternity, Alcohol / Drug, Autism Spectrum Disorders (ASD), etc. Primary duties may include, but are not limited to:</p> <div class="readOnlyFrame"> <ul> <li>Responds to more complex cases and account specific requests.</li> <li>Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs.</li> <li>Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment.</li> <li>Monitors and evaluates effectiveness of care plan and modifies plan as needed.</li> <li>Supports member access to appropriate quality and cost effective care.</li> <li>Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers.</li> <li>Serves as a resource to other BH Case Mgrs.</li> <li>Participates in cross-functional teams, projects and initiatives.</li> </ul> </div>
Requirements: <ul> <li> <div><span style="font-family: arial, sans-serif;">Requires MS or MA in social work, counseling or a related behavioral health field or a degree in nursing</span></div> </li> <li> <div><span style="font-family: arial, sans-serif;">3- 4 years of clinical experience in social work, counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment; or any combination of education and experience, which would provide an equivalent background.</span></div> </li> <li> <div><span style="font-family: arial, sans-serif;">Current active unrestricted license as an RN, LCSW, LMHC, LPC (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.</span></div> </li> <li> <div><span style="font-family: arial, sans-serif;">Previous experience in case management and telephonic coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders.</span></div> </li> <li> <div><span style="font-family: arial, sans-serif;">Managed care experience required.</span></div> </li> <li> <div><span style="font-family: arial, sans-serif;">Experience with Autism Spectrum Disorder is highly preferred.</span></div> </li> <li> <div><span style="font-family: arial, sans-serif;"><span style="font-size: xx-small;"><span style="font-size: medium;">LBA (as allowed by applicable state laws) is preferred.</span></span></span></div> </li> </ul> <p><span style="font-size: xx-small;"><span style="font-size: medium;">*** May be hired as a Behavioral Health Case Manager l, or ll depending upon level of education, skills, and relevant&nbsp;</span><span style="font-size: medium;">experience.***</span></span></p>