Behavioral Health Care Manager II - Autism (ABA/BCBA)
Elevance Health • Durham, NC2d • Remote
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Behavioral Health Care Manager II - Autism (ABA/BCBA)
Elevance Health•Durham, NC
•Remote
About The Position
The Behavioral Health Care Manager II is responsible for managing psychiatric disorder facility-based and outpatient professional treatment health benefits through telephonic or written review. Primary responsibilities include, but are not limited to: Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract. Refers cases to Peer Reviewers as appropriate. Performs psychiatric disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources. Will serve as a resource to other BH Care Managers. Assists with more complex cases and may participate in inter and intradepartmental 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 3 years of experience with facility-based and/or outpatient psychiatric treatment; or any combination of education and experience which would provide an equivalent background.
- Current active unrestricted license such as LBA (as allowed by applicable state laws) or Clinical Psychologist to practice as a health professional within the scope of licensure from the state in which you reside is required.
- Licensure is a requirement for this position.
- 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.
- Previous experience in case management/utilization management with a broad range of experience with complex psychiatric cases required.
- Prior managed care experience required.
Nice To Haves
- Previous experience as a BCBA with a focus in Applied Behavior Analysis (ABA).
- Prior UM/UR experience in behavioral health is preferred.
Responsibilities
- Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract.
- Refers cases to Peer Reviewers as appropriate.
- Performs psychiatric disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.
- Serves as a resource to other BH Care Managers.
- Assists with more complex cases and may participate in inter and intradepartmental teams’ projects and initiatives.
Benefits
- merit increases
- paid holidays
- Paid Time Off
- incentive bonus programs
- medical
- dental
- vision
- short and long term disability benefits
- 401(k) +match
- stock purchase plan
- life insurance
- wellness programs
- financial education resources
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
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