Behavioral Health Care Manager I

Elevance Health•Costa Mesa, CA

6d•Remote

About The Position

JR177525 Behavioral Health Care Manager I The Behavioral Health Care Manager I is responsible for conducting utilization management reviews for mental health and substance use disorder inpatient and outpatient benefits through telephonic and written processes. Also provides telephonic support for crisis intervention, assessment and short-term problem resolution and referral to appropriate provider(s). Location: Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), 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 hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. 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. 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.

Requirements

Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and 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 (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure is required.
Licensure is a requirement for this position.

Nice To Haves

In this role, associates should possess strong oral, written, and interpersonal communication abilities, along with excellent problem-solving, facilitation, independent decision-making, and analytical skills.
Must be proficient in MS Office and have a strong technical aptitude.
Candidates must be licensed and reside in California.

Responsibilities

Conducting utilization management reviews for mental health and substance use disorder inpatient and outpatient benefits through telephonic and written processes.
Provides telephonic support for crisis intervention, assessment and short-term problem resolution and referral to appropriate provider(s).
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.

Benefits

Elevance Health offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements).
merit increases
paid holidays
Paid Time Off
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