Anthem, Inc. Behavioral Health Case Mgr I or II - HARP in Bronx, New York
SHIFT: Day Job
Your Talent. Our Vision. At Empire Blue Cross Blue Shield, a proud member of the Anthem, Inc. family of companies, it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.
Behavioral Health Case Mgr l - HARP Health & Recovery Program – New York City, NY Due to the current COVID-19 (coronavirus) pandemic, this position will work remotely from your home with the flexibility to return to a regular, in-office work environment in New York City. The Behavioral Health Case Manager l for HARP is responsible for performing telephonic case management within the scope of licensure for members with behavioral health and substance use disorder needs. Primary duties may include, but are not limited to: • Uses appropriate screening criteria, knowledge, and clinical judgment to assess member needs. • Conducts assessments to identify individual needs and develops a care plan to address objectives and goals as identified during assessment. • Monitors and evaluates the effectiveness of the care plan and modifies the 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. • Maintains an understanding of behavioral health benefits and remains current on covered or in-plan services, benefit limitations, exclusions, and care management policies and procedures. • Works as an effective member of the care management department and individual team. • Assumes responsibility for member's access to in-plan and/or supplemental services as medically necessary.
• MS or MA in social work, counseling, nursing, or a related behavioral health field; 3 years clinical experience in social work, counseling with a broad range of experience with complex psychiatric and substance use disorder treatment; or any combination of education and experience, which would provide an equivalent background. • Current active unrestricted license as an RN, LCSW, LMSW, LMFT, or LMHC to practice as a health professional within the scope of licensure in the state of New York. • Experience working with Microsoft Office (Outlook, Word, and Excel) Preferred Qualifications: • Knowledge of best practices in behavioral health, including substance use disorders and treatment, emphasizing work with special needs populations and in public sector systems.
• Experience in case management and telephonic coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred. • Knowledge of managed care functional areas, including terms and definitions. • Familiarity with New York State community-based programs, inpatient settings, and ability to do in-person assessments with members and liaise with health plan partners • Proficient with electronic medical records/electronic charting. • Managed care experience a plus.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.