Your Talent. Our Vision. At Amerigroup , a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination. It’s 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.
Behavioral Health Care Manager I/II (Job Family) UM – Atlanta, GA 120598
Work Location: Atlanta, GA office; may transition to work@home after successful completion of approximately 6+months training.
BH Care Manger 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.
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.
- 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.
BH Care Manager II:
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 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 BH Care Managers.
- Assists with more complex cases, and may participate in inter and intradepartmental teams, projects and initiatives.
Qualifications
BH Care Manager I:
Requires MS or MA in social work, counseling, nursing or a related behavioral health field; 3 years 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, LPC, LMFT, or Clinical Psychologist, to practice as a health professional within the scope of licensure in the state of Georgia required.
- Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred.
BH Care Manager II:
- Requires MS or MA in social work, counseling, nursing or a related behavioral health field; 3-4 years 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, LPC, LMFT, or Clinical Psychologist, to practice as a health professional within the scope of licensure in the state of Georgia required.
- 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.
This position is posted as a job family, and selected candidates will be placed into the job level commensurate with their experience.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.
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