Anthem, Inc Manager Behavioral Health Services-Case Management (PS14596) in New Haven, Connecticut

Manager Behavioral Health Services-Case Management (PS14596)

New

Location: United States

Field: Medical

Requisition #: PS14596

Post Date: 4 days ago

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and 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 atone of America's leading health benefits companies and a Fortune Top 50 Company.

Manager Behavioral Health Services-Case Management

Responsible for Medicare Behavioral Health Case Management (BH CM) Team of 17 staff and 18 + Medicare markets and growing.

Primary duties may include, but are not limited to:

  • Serves as a resource for medical management programs.

  • Identifies and recommends revisions to policies/procedures.

  • Ensures staff adheres to accreditation guidelines.

  • Supports quality improvement activities.

  • May assist with implementation of cost of care initiatives.

  • May attend meetings to review UM and/or CM process and discusses facility issues.

  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Responsibilities for BH CM may include:

  • Manages a team of licensed clinicians and non-clinical support staff engaged in telephonic outreach to members; oversees staff assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs; monitors and evaluates effectiveness of care plans; manages case consultation and education to customers and internal staff for efficient utilization of BH services; supports process improvement and quality assurance activities; ensures adherence to appropriate departmental policies, case management best practices, relevant clinical standards, and member contracts; facilitates collaboration across departments to ensure cost effective and quality member care.

  • Additional responsibilities for integrated BH UM and BH CM model include: Integrates the UM/CM functions to improve information flow and collaboration.

Qualifications:

  • Requires current, active, unrestricted license as an RN, LCSW (as applicable by state law and scope of practice), 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.

  • For Government business only: LAPC, LAMFT, and LMSW are also acceptable if allowed by applicable state laws and any other state or federal requirements that may apply; provided that the managers director has one of the types of licensure specified in the preceding sentence.

  • MS degree in social work, counseling, psychology or related behavioral health field or a degree in nursing; five (5) years of clinical experience with facility-based and/or outpatient psychiatric and chemical dependency treatment; extensive experience in case management and telephonic coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders; and experience applying clinical and policy knowledge on the continuum of Behavioral Health treatment

  • Or any combination of education and experience, which would provide an equivalent background.

  • Certification as a Case Manager from the approved list of certifications is preferred.

  • Case Management experience

  • Prior experience in Managed Care setting required

  • Medicare experience preferred

Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.