Behavioral Health Care Manager II

Elevance Health; Miami (FL); Remote; USD 54,000 - 117,000; Full time

Job summary

Elevance Health is seeking a Behavioral Health Care Manager II to oversee utilization management for behavioral health services. This virtual full-time role requires clinical judgment and a strong licensure background, ensuring members receive necessary care while promoting efficient healthcare practices. The position offers flexibility and opportunities for personal and professional growth within a leading healthcare company.

Benefits

Market-competitive total rewards

Paid Time Off

Incentive bonus programs

401(k) match

Wellness programs

Qualifications

• Requires 3 years of experience in psychiatric and substance abuse treatment.
• Licensure is mandatory, with BCBA acceptable under specific conditions.
• Managed care experience is essential.

Responsibilities

• Conducts utilization management reviews for behavioral health services.
• Collaborates on complex cases and assists other Behavioral Health Care Managers.
• Ensures access to quality behavioral healthcare and effective use of resources.

Skills

Clinical judgment

Problem-solving

Interpersonal communication

Education

MA/MS in Social Work, Counseling, or related field

Active unrestricted license as RN, LCSW, LMSW, LMHC, LPC, LMFT, or Clinical Psychologist

Job description

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JR153784 Behavioral Health Care Manager II

The Behavioral Health Care Manager II is a utilization management role and is responsible for utilization management review for Behavior Analysis services.

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.

How Will You 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.
• Will serve as a resource to other Behavioral Health Care Managers.
• Assists with more complex cases and may participate in inter and intradepartmental team’s 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. 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

• 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 Board Certified Behavioral Analyst (BCBA).
• Needs to reside in Florida.
  
  

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.

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.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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.

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.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care

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