Manager II Behavioral Health Svcs (US)

Elevance Health•Washington, DC

4d•Hybrid

About The Position

Manager II Behavioral Health Services Location: Washington, DC. This role requires associates to be in-office 4 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 an accommodation is granted as required by law. The Manager II Behavioral Health Services will be responsible for Behavioral Health Case Management (BH CM). Serves as a mentor to lower leveled managers and as a subject matter expert for other areas of the company and within the department. Develops and manages annual operating budget. How you will make an impact: 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 CM may include: Manages a team of licensed clinicians and non-clinical support staff engaged in telephonic outreach to members; oversees staff assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs; monitors and evaluates effectiveness of care plans; manages case consultation and education to customers and internal staff for efficient utilization of BH services; supports process improvement and quality assurance activities; ensures adherence to appropriate departmental policies, care management best practices, relevant clinical standards, and member contracts; facilitates collaboration across departments to ensure cost effective and quality member care.

Requirements

Requires current, active, unrestricted license such as RN, LCSW (as applicable by state law and scope of practice), LMHC, LPC, LBA (as allowed by applicable state laws), LMFT, LMSW or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States. For Government business only: LAPC, and LAMFT are also acceptable if allowed by applicable state laws and any other state or federal requirements that may apply; provided that the manager’s director has one of the types of licensure specified in the preceding sentence. Licensure is a requirement for this position. 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, and there is licensed staff supervision.
Prior experience in Managed Care setting required.
MS in social work, counseling, psychology or 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 extensive experience in case management and telephonic coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders, which includes minimum of 2 years prior management experience; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Experience applying clinical and policy knowledge on the continuum of Behavioral Health treatment strongly preferred.
Certification as a Case Manager 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 engaged in telephonic outreach to members
Oversees staff assessing, developing, implementing, coordinating, monitoring, and evaluating care plans designed to optimize member health care across the care continuum and ensuring member access to services appropriate to their health needs
Monitors and evaluates effectiveness of care plans
Manages case consultation and education to customers and internal staff for efficient utilization of BH services
Supports process improvement and quality assurance activities
Ensures adherence to appropriate departmental policies, care management best practices, relevant clinical standards, and member contracts
Facilitates collaboration across departments to ensure cost effective and quality member care.