Behavioral Health Case Manager III

Elevance Health•Denver, CO

1d•Remote

About The Position

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) and Maternity Alcohol / Drug Autism Spectrum Disorders (ASD) etc. 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. Serves as a resource to other BH Case Mgrs. Assists with more complex cases and will participate in inter- and intradepartmental teams projects and initiatives. Will serve as key support to the BH Case Manager Lead in implementing identified operational processes/ key projects. Will develop expertise in specified areas of business needs to assist management with unit operations. 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

MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 4 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.
Extensive 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 required.
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.
Candidates must reside in Colorado and be within a reasonable commuting distance of an Elevance Health PulsePoint office.

Responsibilities

Performs 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.
Serves as a resource to other BH Case Mgrs.
Assists with more complex cases and will participate in inter- and intradepartmental teams projects and initiatives.
Serves as key support to the BH Case Manager Lead in implementing identified operational processes/ key projects.
Develops expertise in specified areas of business needs to assist management with unit operations.
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.
Participates in cross-functional teams projects and initiatives.