Behavioral Health Case Manager II

Elevance Health•Los Angeles, CA

11h•Remote

About The Position

Responsible for performing case management telephonically within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs. Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED), Maternity, Alcohol/Drug, Autism Spectrum Disorders (ASD), etc. Primary duties may include but are not limited to: Responds to more complex cases and account specific requests. Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs. Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment. Monitors and evaluates effectiveness of care plan and modifies plan as needed. Supports member access to appropriate quality and cost effective care. Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers. Serves as a resource to other BH Case Mgrs. Participates in cross-functional teams, projects and initiatives. 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. 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.

Requirements

MA/MS in social work counseling or a related behavioral health field, or a degree in nursing, and minimum of 3 years of clinical experience in social work counseling with broad range of experience with complex 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, LMHC, LPC, LMFT, LMSW, or Clinical Psychologist to practice as a health professional issued by the state of California.
Previous experience in case management and telephonic and/or in person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders.
Managed care experience required.

Nice To Haves

Experience with care coordination and discharge planning is strongly preferred.
Experience in health coaching and motivational interviewing techniques preferred.

Responsibilities

Performs case management telephonically within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs.
Acts as a subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED), Maternity, Alcohol/Drug, Autism Spectrum Disorders (ASD).
Responds to more complex cases and account specific requests.
Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs.
Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals.
Monitors and evaluates effectiveness of care plan and modifies plan as needed.
Supports member access to appropriate quality and cost effective care.
Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers.
Serves as a resource to other BH Case Mgrs.
Participates in cross-functional teams, projects and initiatives.