Behavioral Health Care Manager II - ABA at Elevance Health

Cerritos, California, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Behavioral HealthIndustries

Requirements

MA/MS in social work, counseling, or a related behavioral health field, and minimum of 3 years of experience with applied behavioral analysis and autism services (or equivalent combination of education and experience)
Current, active, unrestricted license such as LBA (as allowed by state laws); or for states not requiring licensure, Board Certified Behavioral Analyst (BCBA) acceptable if performing only UM approvals and reviewing ABA service requests
Current, active, unrestricted license such as LMFT or Clinical Psychologist to practice as a health professional within scope of licensure in applicable states or U.S. territory
Previous experience in case management/utilization management with broad range of autism services and treatment
Prior managed care experience

Responsibilities

Manage autism services and behavioral health treatment benefits through 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 per UM Clinical Guidelines and contract
Refer cases to Peer Reviewers as appropriate
Perform ABA initial treatment assessment reviews, treatment monitoring, and evaluation to promote quality member outcomes, optimize health benefits, and promote effective use of health benefits and community resources
Serve as a resource to other BH Care Managers
Assist with more complex cases and participate in inter- and intradepartmental teams, projects, and initiatives

Skills

ABA

Behavioral Health

Autism Services

Utilization Management

Clinical Guidelines

Treatment Assessment

Peer Review

Care Management

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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