Anthem, Inc. Behavioral Health Care Manager in Charlotte, North Carolina
SHIFT: Day Job
Your Talent. Our Vision. At Healthy Blue, a strategic alliance of Blue Cross NC and Amerigroup, an Anthem Inc. company, 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 healthcare.
This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.
LOCATION: Remote from home. North Carolina residency is required.
HOURS: Monday through Friday, 8:00 am - 5:00 pm.
The Behavioral Health Care Manager is responsible for managing psychiatric and substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.
Primary duties may include but are not limited to:
Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost-effective setting in accordance with UM Clinical Guidelines and contract.
Refers cases to Peer Reviewers as appropriate.
Performs psychiatric and substance abuse or substance abuse disorder assessment, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.
Requires a current active unrestricted license as an LCSW, LMSW, LPC, LMFT, LMHC, or RN from the state of North Carolina.
Requires a minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment.
Experience in utilization management with a broad range of experience with complex psychiatric/substance abuse cases is preferred.
Experience in rehabilitation services preferred.
You must be competent in Microsoft Word, Excel, and Outlook.
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. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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.