Manager of Behavioral Health - Indiana SMI Case Management

Elevance Health

1d • Remote

About The Position

Work location: 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. Independent licensure and residency in Indiana is required for this role. The Manager of Behavioral Health – Indiana SMI Case Management is responsible for overseeing a team of clinicians and non-licensed staff supporting the needs of our Indiana members. Primary duties may include but are not limited to: 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. Facilitate collaboration across departments to ensure cost effective and quality member care. Serves as a resource for medical management programs. Identifies and recommends revisions to policies/procedures. Ensure 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 discuss facility issues. Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Requirements

• LICENSURE REQUIREMENTS: Requires current, active, unrestricted license such as RN, LCSW (as applicable by state law and scope of practice), LMHC, LPC, LMSW, LBA (as allowed by applicable state laws), LMFT, 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 licensures 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 the following criteria are met; performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.
• EDUCATION/EXPERIENCE REQUIREMENTS: 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; 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 is preferred.
• Experience working in physical health is strongly preferred.
• Experience working with those with serious mental illness (SMI) is preferred.

Responsibilities

• 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.
• Facilitate collaboration across departments to ensure cost effective and quality member care.
• Serves as a resource for medical management programs.
• Identifies and recommends revisions to policies/procedures.
• Ensure 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 discuss facility issues.
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

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
• Number of Employees: 5,001-10,000 employees