Behavioral Health Care Manager II

Elevance Health; Cincinnati (OH); Remote; USD 71,000 - 124,000; Full time

Job summary

An established industry player is seeking a dedicated Behavioral Health Care Manager II to oversee psychiatric and substance use disorder treatment. This remote role involves assessing member needs, coordinating care, and ensuring access to essential health benefits. With a focus on quality outcomes and effective resource utilization, the ideal candidate will leverage their clinical judgment and problem-solving skills to make a significant impact in the lives of members. The company offers a comprehensive benefits package and values diversity and inclusion, making it an exciting opportunity for professionals passionate about mental health and community support.

Benefits

Comprehensive Benefits Package

Incentive and Recognition Programs

Equity Stock Purchase

401k Contribution

Qualifications

• Requires MA/MS in social work, counseling, or nursing with 3+ years of experience.
• Current active unrestricted license required for health professionals.

Responsibilities

• Manage psychiatric and substance use disorder treatment through telephonic reviews.
• Assess member needs to ensure access to quality behavioral healthcare.

Skills

Clinical Judgment

Problem-Solving Skills

Interpersonal Communication

Analytical Skills

Education

MA/MS in Social Work or Counseling

Degree in Nursing

Tools

Utilization Management

Applied Behavior Analysis (ABA)

Job description

A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

Behavioral Health Care Manager II

Location: This is a remote, work from home position. The ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

The Behavioral Health Care Manager II is responsible for managing psychiatric and substance use 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.

• Performs psychiatric and 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.

• 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 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.

• 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 Skills, Capabilities and Experiences:

• Experience in Utilization Management preferred.

• Board Certified Behavioral Analyst (BCBA) or Licensed Behavioral Analyst (LBA) strongly preferred.

• Experience in applied behavior analysis therapy (ABA) 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.

For candidates working in person or remotely in the below location(s), the salary range for this specific position is $71,820 to $123,120.

Locations: California, New York.

In addition to your salary, Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).

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.

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 [e-mail] for assistance.