Anthem, Inc. BH Case Mgr I in South Portland, Maine
SHIFT: Day Job
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 at one of America's leading health care companies and a Fortune Top 50 Company.
BH Case Manager I
This position is a telephonic and field based position that will be located in Wisconsin with up to 50% of local travel within assigned territory. Note: Temporarily not doing field work. Telephonic outreach only due to the pandemic.
Location: Wisconsin Statewide
Responsible for telephonic and field-based care case management within the scope of licensure for members with complex and chronic care needs by assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum. Performs duties telephonically or on-site such as at hospitals for discharge planning. .
Primary duties may include, but are not limited to: • Ensures member access to services appropriate to their health needs. • Conducts comprehensive assessments to identify individual needs and develops a member-centric specific care management treatment plan to address objectives and goals as identified during assessment. • Implements care plan by facilitating authorizations/referrals as appropriate within benefits structure or through extra-contractual arrangements. • Coordinates internal and external resources to meet identified needs. • Monitors and evaluates effectiveness of the care management treatment plan and modifies as necessary. • Interfaces with Medical Directors and Physician Advisors on the development of care management treatment plans. • Assists in problem solving with providers, claims or service issues. • Assists with development of utilization/care management policies and procedures • Ensures member access to services appropriate to their health needs. • Works as part of an integrated team to ensure best health outcomes of assigned members.
• Requires MS or MA in social work, counseling, or a related behavioral health field • 3 years clinical experience in social work or counseling with broad range of experience with complex psychiatric and substance abuse treatment; or any combination of education and experience, which would provide an equivalent background. • Current active unrestricted license as an LCSW, or LPC or LMFT (as applicable by state law and scope of practice) • Experience in case management and telephonic coaching with members preferred. • Substance Abuse Counselor Certification preferred • Local travel required • Bilingual in Spanish strongly preferred
*Note: Due to the pandemic field-work is currently on hold but will be part of the duties in the future.
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.