Behavioral Health Case Manager II

Elevance Health•Costa Mesa, CA

41d•Hybrid

About The Position

Shift: Monday - Friday 8:00am - 5:00pm PST Location: California, within a commutable distance to a PulsePoint office; Some field-based work required 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. The Behavioral Health Case Manager II is responsible for performing case management telephonically and/or by home visits 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. How you will make an impact: 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.

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 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 RN LCSW LMHC LICSW LPC (as allowed by applicable state laws) LMFT LMSW (as allowed by applicable state laws) or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.
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.
For Government business only LAPC LAMFT (as allowed by applicable state laws) is also acceptable in addition to other licensure referenced above; and any other state or federal requirements that may apply.

Nice To Haves

Experience in health coaching and motivational interviewing techniques preferred.
For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required for this position.

Responsibilities

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.