Behavioral Health Case Manager II at Elevance Health

New York, New York, United States

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Not SpecifiedCompensation

Mid-level (3 to 4 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 clinical experience in social work or counseling with a broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment (or equivalent combination of education and experience)
Current active unrestricted license such as RN, LCSW, LMHC, LICSW, LPC (as allowed by applicable state laws), LMFT, LMSW (as allowed by applicable state laws), or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States (For Government business only, LAPC or LAMFT as allowed by applicable state laws is also acceptable; any other state or federal requirements that may apply)
Previous experience in case management and telephonic and/or in-person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders
Managed care experience required
For associates working within Puerto Rico who are member or patient facing either in a clinical setting or in the Best Transportation unit, a current PR health certificate and a current PR Law 300 certificate are required

Responsibilities

Responds to more complex cases and account specific requests
Uses appropriate screening criteria knowledge and clinical judgment to assess member needs
Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment
Monitors and evaluates effectiveness of care plan and modifies plan as needed
Supports member access to appropriate quality and cost effective care
Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers
Serves as a resource to other BH Case Managers
Participates in cross-functional teams, projects, and initiatives
Performs case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs

Skills

Key technologies and capabilities for this role

Case ManagementBehavioral HealthSubstance AbuseTelephonic AssessmentCare PlanningClinical JudgmentScreening CriteriaEating DisordersAutism Spectrum DisordersSocial Work

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. Candidates must be within a reasonable commuting distance from the posting location(s) in New York, NY, unless an accommodation is granted.

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 clinical experience in social work counseling with broad range of experience with complex psychiatric and substance abuse treatment. Current active unrestricted license such as RN, LCSW, LMHC, or others is required, along with previous experience in case management and managed care.

What licensure is required for this role?

A current active unrestricted license such as RN, LCSW, LMHC, LICSW, LPC, LMFT, LMSW, or Clinical Psychologist is required to practice as a health professional within the scope of licensure in applicable states. For Government business, LAPC or LAMFT is also acceptable as allowed by state laws.

What are the working hours for this position?

The hours are 8:00AM - 5:00PM in local time.

What experience makes a strong candidate for this role?

Strong candidates have 3+ years of clinical experience with complex psychiatric and substance abuse disorders, previous case management experience, managed care background, and expertise in areas like Eating Disorders, Maternity, Alcohol/Drug, or Autism Spectrum Disorders. Experience with telephonic and in-person coaching is also key.

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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