This position is both telephonic and field-based. You will support our members with approximately 50% of field work in the San Antonio territory. ( Note : Temporarily not doing field work. Telephonic outreach only due to the pandemic). Responsible for performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health, physical health and substance abuse or substance abuse disorder needs.
Primary duties may include 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. (Temporarily, outreach is telephonic only due to the pandemic.)
- 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.
- 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.
- Serves as a resource to other Case Managers.
- Participates in cross-functional teams projects and initiatives.
- Must be located in the San Antonio, TX area and have the ability to travel (temporarily telephonic only due to the pandemic) up to 50% in the San Antonio, TX area.
- Requires MS or MA in social work counseling or a related behavioral health field ( or) a degree in nursing; 3- 4 years of clinical experience in social work counseling with broad range of experience with complex psychiatric, complex medical and substance abuse or substance abuse disorder treatment; or any combination of education and experience which would provide an equivalent background.
- Requires professional licensure such as an LPC, LCSW, LMFT or RN to practice as a mental health service professional within the state of Texas.
- 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.
- 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.ElevanceHealth.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.