Behavioral Health Care Manager II - Virginia
Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy.
The successful candidate will hold an independent behavioral health state licensure, such as an LCSW or an LPC. Virginia licensure is strongly preferred but not required.
The Behavioral Health Care Manager II - Virginia is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.
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.
forms psychiatric 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.
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, 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.
Licensure is a requirement for this position.
For states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.
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.
Preferred Qualifications, Skills, and Experiences
Utilization review experience in outpatient setting is strongly preferred.
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. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.