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BH Care Manager I - PS 19094 - Pomona, CA #6235722

Company: Anthem, Inc

Date: 03/26/2019

Category: Insurance

City: Pomona, CA

BH Care Manager I - PS 19094

Location: United States


Field: Medical

Requisition #: PS19094

Post Date: 7 hours ago

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater 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 benefits companies and a Fortune Top 50 Company.

This position will allow you to work remotely but you must reside in the State of Iowa.

The Behavioral Health Care Manager I 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.

Primary duties may include but are not limited to:

  • Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access tomedically 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.

  • MS or MA in social work counseling or a related behavioral health field or a degree in nursing; 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 as an RN, LCSW, LMSW, LMHC, LPC, LBA, LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in the State of Iowa.

  • Previous experience in case management / utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.

  • Prior managed care or healthcare insurance experience preferred.

  • Proficiency in Microsoft suite such as Word, Excel and Outlook preferred.

  • Proficiency in using phones preferred.

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and s a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at An Equal Opportunity Employer/Disability/Veteran.

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