Behavioral Health Care Manager I

Elevance Health (Anthem); Cincinnati (OH); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Elevance Health seeks a Behavioral Health Care Manager I to manage psychiatric and substance use benefits via telephonic and written review, with in-person training as required. This role supports access to medically necessary behavioral health care in a cost-effective setting.

The candidate will assess member needs, coordinate reviews, and ensure quality outcomes within UM guidelines. Must hold an active license and have 3+ years in relevant behavioral health settings, preferably Ohio-based.

Qualifications

• Minimum requirements include MA/MS in social work, counseling or nursing with 3+ years of psychiatric/substance abuse treatment experience.
• Active unrestricted license (RN, LCSW, LMSW, LMHC, LPC, LMFT, or Psychologist) per state laws.
• License required to practice as health professional; BCBA acceptable only under specific UM approvals.

Responsibilities

• Assess member needs using screening criteria and clinical judgment to ensure access to appropriate behavioral health care.
• Refer cases to Peer Reviewers as appropriate and coordinate reviews.
• Coordinate coordination, implementation, case planning, monitoring and evaluation to promote quality member outcomes and optimal health benefits.

Skills

Crisis call center

Ohio license

Spanish bilingual

Independent practice license

Case management/UM

Education

MA/MS in social work or counseling, or nursing degree

Job description

Anticipated End Date: 2026-10-02

Position Title: Behavioral Health Care Manager I

Job Description:

Behavioral Health Care Manager I

Virtual: This role enables associates to work virtually full-time, except for required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered if candidates reside within a commuting distance from an office.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law.

Work Hours: Monday - Friday 11AM - 8PM, covers holidays

The Behavioral Health Care Manager I 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

Primary duties may include, but are not limited to:

• 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.
• Refs 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 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. However, 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.

Preferred Skills, Capabilities and Experiences:

• Crisis call center experience is preferred
• Licensed in Ohio is highly preferred
• Bilingual in Spanish is preferred
• Licensed to practice independently is highly preferred
• Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.

For URAC Accredited Areas, the following professional competencies apply:

Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Job Level:

Non-Management Exempt

Workshift:

2nd Shift (United States of America)

Job Family:

MED > Licensed/Certified Behavioral Health Role

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

Benefits

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Workforce Strategy

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at a