JR168679 Behavioral Health Care Manager I
The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder inpatient and outpatient benefits through telephonic and written processes. Also provides telephonic support for crisis intervention, assessment and short-term problem resolution and referral to appropriate provider(s).
Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.
Schedule: Monday - Friday, 8am-5pm
How you will make an impact:
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.
Minimum Requirements:
Requires 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 RN LCSW LMSW LMHC LPC (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure is required.
Licensure is a requirement for this position.
Preferred Skills, Capabilities, and Experiences:
In this role, associates should possess strong oral, written, and interpersonal communication abilities, along with excellent problem-solving, facilitation, independent decision-making, and analytical skills.
Must be proficient in MS Office and have a strong technical aptitude.
Candidates from all states are welcome, but they must reside within commuting distance of a Pulse Point office 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. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.