Behavioral Health Case Manager II
Schedule: 8a - 5p CST | Monday - Friday
Location: Nashville, TN - Hybrid remote + fieldwork (~50%)
Fieldwork in: Davidson, Rutherford, Sumner and Wilson counties
Please note: The BH Case Mgr (CM) job progression is primarily member-facing and involves complete clinical assessment. Whereas the BH Care Manager (UM) job progression is primarily a provider-facing role although it does involve some member-facing activities such as collecting information and using clinical knowledge and expertise to ensure our members are directed to the appropriate level of care.
Build the possibilities. Make an extraordinary impact:
- Responsible for performing 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.
- Subject matter expert in targeted clinical areas of expertise such as Eating Disorders (ED) Maternity Alcohol / Drug Autism Spectrum Disorders (ASD) etc.
How you will make an impact (including but are not limited to):
- Completes face-to-face visits with the member in the home, hospital, and other community settings, such as doctor's offices, treatment centers, etc.
- 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 Behavioral Health Case Managers
- Participates in cross-functional teams -projects and initiatives.
- Identifies members at high risk for complications and coordinates care in conjunction with the member and the health care team.
- Identifies members that would benefit from an alternative level of care or other waiver programs.
- Assists in problem-solving with providers and the health care team.
- 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 or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background.
- 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 required.
- 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 Government business only LAPC LAMFT (as allowed by applicable state laws) is also acceptable in addition to other licensure referenced above; and any other state or federal requirements that may apply.
Preferred Skills, Capabilities, and Experiences:
- Experience in health coaching and motivational interviewing techniques.
- Experience working on multiple computer platforms simultaneously.
- Excellent typing skills.
- Experience working in a field-based position.
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
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.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact email@example.com for assistance.