Behavioral Health Care Manager I

Elevance Health • Tampa, FL

30d • Remote

About The Position

Behavioral Health Care Manager I Location: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Ideal candidate would reside in the state of Florida. Work Schedule- Tuesday - Saturday: 10a - 6p EST or 11a - 7p EST (weekend hours are flexible) The BH Care Manager I is primarily responsible for managing neurodevelopmental condition, psychiatric disorders as well as substance abuse disorders, facility-based and outpatient professional treatment, Applied Behavioral Analysis health benefits through telephonic or written review. How you will make an impact: 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.

Requirements

• Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing.
• minimum of 3 years of experience with Applied Behavioral Analysis services, facility-based and/or outpatient neurodevelopmental conditions, 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 license, such as RN LCSW LMSW 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 required.
• Licensure is a requirement for this position. However, for states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.

Nice To Haves

• Previous experience in case management/utilization management with a broad range of experience with complex psychiatric, neurodevelopment conditions, and substance abuse cases preferred.
• Board Certified Behavioral Analyst (BCBA) preferred.

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.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level