Behavioral Health Care Manager I - California

Elevance Health•Cerritos, CA

1d•Hybrid

About The Position

Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler. They are transforming into a lifetime trusted health partner, serving approximately 100M+ people. The Behavioral Health Care Manager I is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. This role is designed to be virtually full-time, with the exception of required in-person training sessions, offering flexibility while ensuring essential face-to-face onboarding and skill development. Candidates must be within a reasonable commuting distance from the posting location(s) for potential in-person requirements.

Requirements

MA/MS in social work counseling or a related behavioral health field or a degree in nursing
Minimum of 3 years of 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 California license, such as RN LCSW LMHC LPC LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in California

Nice To Haves

Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases
Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
Crisis call center experience
UM experience
Managed Care experience

Responsibilities

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 UM 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.