Anthem, Inc. BH Care Manager I in New York City, 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.
BH Care Manager I
This is a position for a New York licensed behavioral health clinician able to work at home and available to work in the NY office at 9 Pine St. if necessary.
Responsible for managing psychiatric and substance abuse or 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 MS or MA 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 any combination of education and experience which would provide an equivalent background. Previous experience working with managed care preferred. Experience discharge planning within NYC based providers and levels of care preferred.
-Current, active, unrestricted NY license as an RN LCSW LMSW LMHC LMFT or PhD required.
-Computer skills: You will be working daily with MS Word, MS Outlook, MS Excel, Facets, Maccess, Care Compass, SharePoint and a Fax queue. You will receive training on Anthem specific applications, however, you must be comfortable working on a laptop with web-based applications. You must have experience working with MS Word, Outlook and Excel. If you are not computer savvy this may hinder your ability to be successful in this position.
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.