Behavioral Health Care Manager II - ABA

Elevance Health • Costa Mesa, CA

38d • Remote

About The Position

A proud member of the Elevance Health family of companies, Carelon Behavioral Health, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care. Behavioral Health Care Manager II - ABA Location: Virtual - 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 hybrid/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. Work Shift Hours: Monday through Friday, 8:00 am to 5:00 pm The Behavioral Health Care Manager II is responsible for managing autism services and behavioral health treatment benefits through 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. Performs ABA initial treatment assessment reviews and treatment monitoring and evaluating 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.

Requirements

• Requires MA/MS in social work counseling or a related behavioral health field, and minimum of 3 years of experience with applied behavioral analysis and autism services; or any combination of education and experience which would provide an equivalent background.
• Current, active, unrestricted license such as a LBA (as allowed by applicable state laws). 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.
• Current, active, unrestricted license such as a either a 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 or certification is a requirement for this position.
• Previous experience in case management/utilization management with a broad range of experience with autism services and treatment required.
• Prior managed care experience required.

Nice To Haves

• 3 years of experience in giving feedback on ABA treatment plans and clinical recommendations.
• Strong written and verbal communication skills.
• Ability to work in a collaborative environment.

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 ABA initial treatment assessment reviews and treatment monitoring and evaluating 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.

Benefits

• In addition to your salary, 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).
• 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
• Industry: Insurance Carriers and Related Activities
• Number of Employees: 5,001-10,000 employees