Manager Behavioral Health Services (Chester Co.)

Elevance Health • Philadelphia, PA

6d • Hybrid

About The Position

Manager Behavioral Health Services LOCATION: This position requires 3 days per week in-office. You must reside in or very near Chester County, PA. HOURS: General business hours, Monday through Friday. (Core hours: 8-5) Hybrid 2: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. 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. The Manager Behavioral Health Services is responsible for Behavioral Health Utilization Management (BH UM) and Behavioral Health Case Management (BH CM) (integrated model). Primary duties may include but are not limited to: Serves as a resource for medical management programs. Identifies and recommends revisions to policies/procedures. Ensures staff adheres to accreditation guidelines. Supports quality improvement activities. May assist with implementation of cost of care initiatives. May attend meetings to review UM and/or CM process and discusses facility issues. Hires, trains, coaches, counsels, and evaluates performance of direct reports. Responsibilities for BH UM may include: UM: Manages a team of licensed clinicians and non-clinical support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services. CM: Manages a team of licensed clinicians and non-clinical support staff engaged in telephonic outreach to members. Monitors and evaluates the effectiveness of care plans; manages case consultation and education to customers and internal staff for efficient utilization of BH services;. Additional responsibilities for integrated BH UM and BH CM model include integrating the UM/CM functions to improve information flow and collaboration.

Requirements

• Requires MA/MS in social work, counseling or a related behavioral health field, or a degree in nursing, and minimum of 5 years of clinical experience with facility-based and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience.
• Requires a current active unrestricted license such as LCSW, LMHC, LICSW, LPC, LMFT, RN or Clinical Psychologist to practice as a health professional from the Commonwealth of Pennsylvania.
• 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.

Nice To Haves

• Behavioral Health treatment strongly preferred.
• Experience applying clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred.
• Certification as a Case Manager is preferred.

Responsibilities

• Serves as a resource for medical management programs.
• Identifies and recommends revisions to policies/procedures.
• Ensures staff adheres to accreditation guidelines.
• Supports quality improvement activities.
• May assist with implementation of cost of care initiatives.
• May attend meetings to review UM and/or CM process and discusses facility issues.
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.
• Manages a team of licensed clinicians and non-clinical support staff responsible to ensure medical necessity and appropriateness of care for inpatient/outpatient BH services.
• Manages a team of licensed clinicians and non-clinical support staff engaged in telephonic outreach to members.
• Monitors and evaluates the effectiveness of care plans; manages case consultation and education to customers and internal staff for efficient utilization of BH services
• Integrating the UM/CM functions to improve information flow and collaboration.

Benefits

• 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: Manager