Behavioral Health Care Manager I - North Carolina (Day Shift) at Elevance Health

North Carolina, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

MA/MS in social work, counseling, or a related behavioral health field, or a degree in nursing
Minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment (or equivalent combination of education and experience)
Current active unrestricted license such as RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by 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 (licensure required; for states without licensure requirement, BCBA acceptable if performs only UM approvals for ABA services under licensed staff supervision)
Located within reasonable commuting distance from North Carolina (unless accommodation granted)
Strong oral, written, and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills (for URAC accredited areas)

Responsibilities

Manage psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review
Use appropriate screening criteria knowledge and clinical judgment to assess member needs, ensuring access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract
Refer cases to Peer Reviewers as appropriate
Perform psychiatric and substance abuse or substance abuse disorder assessment, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes, optimize member health benefits, and promote effective use of health benefits and community resources

Skills

Key technologies and capabilities for this role

Behavioral HealthCare ManagementUtilization ManagementPsychiatric AssessmentSubstance AbuseCase ManagementClinical GuidelinesTelephonic ReviewSocial WorkNursing

Questions & Answers

Common questions about this position

Is this position remote or virtual?

This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. Candidates must be within a reasonable commuting distance from the posting location(s) in North Carolina.

What are the minimum education and experience 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. Current active unrestricted license such as RN, LCSW, LMSW, LMHC, LPC, LBA, LMFT or Clinical Psychologist is required.

What are the work shift options for this role?

The available shifts are Monday-Friday 8am-5pm EST, Monday-Friday 9am-6pm EST, or Monday-Friday 11am-8pm EST.

What salary or compensation does this position offer?

This information is not specified in the job description.

What preferred skills will make my application stand out?

Preferred qualifications include previous experience in case management/utilization management with complex psychiatric/substance abuse cases, willingness to get an OH License, and being bilingual in Spanish.

Elevance Health

Integrated health services and digital platform

About Elevance Health

Elevance Health focuses on enhancing the health of individuals throughout their lives by evolving from a traditional health benefits organization into a comprehensive health partner. The company serves over 118 million people, providing support at every stage of health through an integrated approach that addresses a wide range of health needs. Their services are backed by advanced capabilities and a digital health platform that streamlines access to care. Unlike many competitors, Elevance Health emphasizes a holistic view of health, aiming to redefine health and improve community well-being. The ultimate goal is to make health improvements accessible to everyone.

Indianapolis, IndianaHeadquarters

1944Year Founded

$309.4MTotal Funding

IPOCompany Stage

Enterprise Software, Social Impact, HealthcareIndustries

10,001+Employees

Benefits

Medical, dental, & vision insurance

401(k) + match

Paid holidays

Paid Time Off

Incentive bonus programs

Stock purchase plan

Life insurance

Wellness Programs

Financial education resources

Adoption & Surrogacy Assistance

Dependent-care Flexible Spending Account (DCFSA)

Parental Leave

Parental Transition Week

Critical Caregiving Leave

Risks

Departure of CFO John Gallina may create a gap in financial leadership.

Lawsuit against CMS over MA Star Ratings could lead to financial penalties.

CareBridge integration may face operational challenges, disrupting service delivery.

Differentiation

Elevance Health integrates whole health approach with digital health platform for comprehensive care.

Acquisition of CareBridge enhances home health services within Carelon division.

Strategic partnership with Clayton, Dubilier & Rice aims to innovate primary care delivery.

Upsides

AI integration in home health services can reduce hospital readmissions and improve outcomes.

Predictive analytics support early disease detection, aligning with Elevance's whole health approach.

Telehealth expansion offers opportunities to reach more patients remotely.

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