Senior Business Manager – Complaints Strategy & Insights
Capital One
Behavioral Health Care Manager I
Elevance Health
full-time
Posted on:
Location: 🇺🇸 United States
Visit company websiteJob Level
Mid-LevelSenior
About the role
- The BH Care Manager I manages psychiatric and substance abuse disorder facility-based and outpatient treatment benefits through telephonic or written review
- Uses screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary behavioral healthcare in a cost-effective setting per UM Guidelines and contract
- Refers cases to Peer Reviewers as appropriate
- Performs psychiatric and substance abuse assessment, coordination, implementation, case planning, monitoring and evaluating to promote quality member outcomes and to promote effective use of health benefits and community resources
Requirements
- Requires 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 and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background
- Current, active, unrestricted license, such as RN (must have exp. in behavioral health), LCSW, LMHC, LPC, or LMFT to practice as a health professional within the scope of licensure in Indiana; licensure is a requirement
