Anthem, Inc. Behavioral Health Care Manager II in Somerville, Massachusetts
SHIFT: Day Job
Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, 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.
For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.
Position: Behavioral Health Care Manager II Location: Remote near Boston, MA preferred - New England residents are welcome to apply. Shift: 11:00am -7:30pm EST
The Behavioral Health Care Manager II is responsible for managing psychiatric and substance abuse or substance use 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 criteria to determine quality behavioral healthcare needs in a cost effective setting in accordance with UM Clinical Guidelines and contract.
Performs psychiatric and substance use or substance use disorder assessment, coordination, collaboration with providers and implementation of 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.
Case consultations with peers and supervisors regarding least restrictive outcomes.
Follow Documentation protocols to ensure next steps on cases are clearly identified.
Refers cases to Peer Reviewers as appropriate.
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.
Address member Crisis calls and give referrals when needed.
Ensure that telephone answering protocols and contractual obligations are met.
Education & Experience: M.S. or M.A. in social work or a related behavioral health field or a degree in psychiatric nursing required; 3-4 years of experience with outpatient psychiatric and substance use treatment required; or any combination of education and experience which would provide an equivalent background
Licensure Current active unrestricted independent clinical license in the state of MA such as LICSW, LMHC, LMFT, or RN to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.
Must be willing to work one or two weekend shifts per month as well as holidays as needed.
Must be willing to work hours of 11:00am-7:30pm EST.
Crisis work or emergency services experience preferred.
Previous experience in case management/utilization management preferred.
Able to work Tuesday to Saturday shift. Highly desired but not required.
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.
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2020 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. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.