BH Case Manager II

Description

A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

This is an individual contributor role and the person in this position must live within 50 miles of an Elevance Health office location. Work schedule: Monday - Friday, 8:00 am to 5:00 pm CST.

The Case Manger will use clinical and CMSA standards to provide care management to Beacon members on an ongoing basis, within the member’s benefit package.  The Case Manager will initiate and maintain communication with members, members’ families, primary care physicians, behavioral health providers and other health team members regarding care management plans, in order to collaborate to meet member’s identified needs. The Case Manager is responsible for conducting outreach, assessment, and care coordination for identified case management enrollees.  The Case Manager works in collaboration with health plan staff and others to ensure quality, and effective, service and support to members.

Primary duties may include, but are limited to:

• Completes comprehensive assessment of the medical, behavioral health and psychosocial needs of identified members, in order to establish, and implement, culturally competent care management plans to address identified needs. Referrals for case management may originate from members, or their families, the health plan, enrollment or trigger reports, or other case identification sources. 
• Completes face-to-face visits with members and their families within inpatient settings and/or their homes, as needed.  Creates patient-centered and culturally competent Individualized Care Plan (ICP) to include problem identification, goal setting, interventions and expected outcomes. 
• Facilitates and coordinate the appropriate services and supports to meet the needs of enrollees, particularly high-risk populations. 
• Provides health coaching and education to members related to health care conditions and treatment plans with a focus on medication and treatment adherence, appropriate use of emergency room, and navigation of the health care system. 
• Directs members to self-management tools and resources and support in their use. 
• Collaborates with medical care managers, pharmacy staff and other community stakeholders to develop a comprehensive and integrated approach to care coordination. 
• Participates in clinical rounds to promote integrated case discussions and solution-focused outcomes. 
• Makes timely referrals for community-based services. 
• Manages members experiencing crisis episodes and facilitates coordination of care as needed. 
• Documents case management activities in approved platforms according to Carelon standard operating procedures. 
• Demonstrates flexibility and creativity in the design of innovative and individualized care plans in order to achieve maximum effectiveness and optimal outcomes for members and their families. 
• Travels to secondary site locations, facility sites and/or community-based health care provider sites as required by Carelon and/or health plan business needs. 
• Participates in facility-based treatment team meetings to support integrated efforts and collaboration with the health care team. 
• Provides assistance, advocacy, and empowerment to members in efforts to achieve optimal health. 
• Adheres to all Carelon policies and procedures and standards of operations. 
• Completes all required and assigned trainings.
• Attends all mandatory company or department meetings. 
• Reports to each scheduled shift on time; commences work and performs essential job functions at the start of each schedule shift. 
• Displays a positive, constructive, and helpful demeanor that is conducive to a safe and respectful work environment. 
• Serves as a mentor to junior team members through leadership and guidance based on integrity, positive example and a sense of team cohesiveness. 
• Assists team members and offers suggestions to improve processes, training, culture, or work environment.
• Performs special projects and other duties as assigned and required.

Minimum Requirements:

• 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, LMSW, LPC (as allowed by applicable state laws) LMFT (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.
• Experience in health coaching and motivational interviewing techniques preferred.

Preferred Skills, Capabilities, and Experiences:

• Case management experience highly desirable.
• Bilingual in Spanish preferred.

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. A Fortune 20 company with a longstanding history in the healthcare industry, 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.

Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles 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 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. 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 ability@icareerhelp.com for assistance.