Behavioral Health Care Manager I (UM/UR)

Elevance Health•Rancho Cordova, CA

1d•Remote

About The Position

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. Carelon Behavioral Health, a member of the Elevance Health family of companies, offers clinical mental health and substance use disorder management, employee assistance programs, work/life support, specialty programs for autism and depression, and insightful analytics to improve care delivery. Elevance Health is a health company dedicated to improving lives and communities and making healthcare simpler, focused on whole health and transforming into a lifetime trusted health partner.

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 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 license, such as LCSW, LMSW, LMHC, LPC LMFT, RN or Clinical Psychologist to practice as a health professional within the scope of licensure from the state of California is required.

Nice To Haves

Previous experience in utilization management with a broad range of experience with complex psychiatric/substance abuse cases -- facility based -- is preferred.
Proficient in Microsoft Office Suite (including Word and Outlook).
Ability to quickly learn and adapt to new technologies.
Strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

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.