Anthem, Inc. BH Utilization Management Care Manager I Texas in Houston, Texas
SHIFT: Day Job
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 access to 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
Due to the current COVID-19 (coronavirus) pandemic, you can work remotely from your home for now. Incumbent must reside within commuting distance (1 hour or less) to one of the following locations. • Houston • Dallas • Austin • San Antonio 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 Utilization Management 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.
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, LMHC, LPC, LMFT, or Clinical Psychologist, to practice as a health professional within the scope of licensure in Texas is required. Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases preferred
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.