Care Manager II – Utilization Management

Elevance Health

Behavioral health care manager administering psychiatric and substance-use treatment benefits for Elevance Health. Conducting utilization reviews, case planning, monitoring, and complex-case coordination.

Posted 8/5/2026full-timeRemote • California • 🇺🇸 United StatesMid-LevelSenior💰 $79,948 - $119,922 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in managing psychiatric and substance abuse treatment through effective case management and utilization management, ensuring access to quality behavioral healthcare. Proficient in applying clinical guidelines and promoting optimal member health outcomes.

Highest-signal resume keywords

MA/MS In Social Work, Counseling, Or Related Behavioral Health FieldCurrent, Active, Unrestricted License (LCSW, LMSW, LMHC, LPC, LMFT, Clinical Psychologist)Case Management/Utilization Management ExperienceManaged Care ExperienceStrong Oral, Written, And Interpersonal Communication Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Psychiatric AssessmentSubstance Abuse AssessmentClinical JudgmentUtilization ManagementCase PlanningMonitoring And EvaluationAnalytical SkillsProblem-Solving SkillsFacilitation Skills

Soft Skills

Interpersonal CommunicationTeam Collaboration

Industry Keywords

Behavioral HealthcarePeer ReviewHealth BenefitsCommunity ResourcesCalifornia Licensed Clinician

About the role

Key responsibilities & impact

Manage psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review
Use screening criteria knowledge and clinical judgment to assess member needs and ensure access to medically necessary, quality behavioral healthcare in a cost-effective setting
Apply UM Clinical Guidelines and contract requirements
Refer cases to Peer Reviewers as appropriate
Perform psychiatric and substance abuse assessment coordination, implementation, case planning, monitoring, and evaluation
Promote quality member outcomes and optimize member health benefits
Promote effective use of health benefits and community resources
Serve as a resource to other Behavioral Health Care Managers
Assist with more complex cases
Participate in inter- and intradepartmental team projects and initiatives

Requirements

What you’ll need

MA/MS in social work, counseling, or a related behavioral health field, and minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment; or an equivalent combination of education and experience
Current, active, unrestricted license such as LCSW, LMSW, LMHC, LPC, LMFT, or Clinical Psychologist license required
Previous case management/utilization management experience with complex psychiatric/substance abuse cases required
Prior managed care experience
Strong oral, written, and interpersonal communication skills
Problem-solving skills
Facilitation skills
Analytical skills
California licensed clinician highly preferred
Ability to work Monday–Friday, 8:30 am–5:00 pm Pacific Standard Time
Candidates must reside within a reasonable commuting distance from a posting location unless an accommodation is granted
New candidates in certain patient/member-facing roles must become vaccinated against COVID-19 and Influenza, unless an acceptable explanation is provided

Benefits

Comp & perks

Comprehensive benefits package
Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs
Medical benefits
Dental benefits
Vision benefits
Short-term disability benefits
Long-term disability benefits
401(k) with match
Stock purchase plan
Life insurance
Wellness programs
Financial education resources
Required in-person training sessions
Flexible virtual work arrangement