Anthem, Inc. Behavioral Health Care Manager I or II National Accounts Team in St. Louis, Missouri
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 Care Manager I or II Job Family *May be hired as a Behavioral Health Care Manager Level l, or Level ll depending upon the level of education, skills, and relevant experience.
Responsible for managing facility-based care with Psychiatric and Substance Abuse facility-based and outpatient benefits through telephonic or written review. Facility-based care includes Acute Inpatient, Detox, Residential, Partial Hospitalization, and Intensive Outpatient levels of care. 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 following UM Clinical Guidelines and contract. • Refers cases to Peer Reviewers as appropriate. • Performs facility-based, psychiatric and substance abuse initial reviews and assessment of care, and continued stay reviews to ensure coordination, of care, case planning, monitoring, and evaluating facility-based care 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. • This Care manager job requires the candidate to be able to type very fast while they talk to the Utilization Review staff person on the phone and receiving from them specific details about how a member (patient) is doing. • Review information is either provided on the phone live or from their voicemail. • Work on multiple computer platforms simultaneously to manage caseload in addition to excellent typing skills
Minimum Qualifications BH Care Manager I or II • Requires a Master’s degree in social work, counseling, or a degree in nursing. 3 years of clinical experience providing treatment to individuals with complex psychiatric and or substance use disorder diagnosis or any combination of education and experience which would provide an equivalent background. • Requires Current active unrestricted license to practice as an RN LCSW LPC LMFT LMHC or Clinical Psychologist within the scope of licensure in the state you reside in
Preferred Qualifications • Experience in case management or utilization management • Experience in managed care • Experience working on multiple computer platforms simultaneously • Excellent typing skills *May be hired as a Behavioral Health Care Manager Level l, or Level ll depending upon the level of education, skills, and relevant experience. Applicable to Colorado Applicants Only Annual Salary Range*: $61,236 - $76,545 Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. * The salary range is the range Anthem in good faith believes is the range of possible compensation for this role at the time of this posting. The Company may ultimately pay more or less than the posted range. This range is only applicable for jobs to be performed in Colorado. This range may be modified in the future. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law. 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. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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.