A proud member of the Elevance Health family of companies, Carelon Behavioral Health, 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. 

Manager, Behavioral Health Clinical Services

Location: This position is required to work a Hybrid Model (office and remote). Ideal candidates Must live within 50 miles to an Elevance Health corporate office.

Work Shift: Monday through Friday, 8 am to 5 pm (EST)

The Manager, Behavioral Health Clinical Services is responsible for managing the clinical operations department. Manages the delivery of quality care management, clinical utilization and referral services.

How you will make an impact:

• Reviews for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply criteria and render certification decisions that are within the scope of practice that is relevant to the clinical areas under review. 

• Identifies areas for quality improvement and implements QI activities. Interfaces with internal and external customers to ensure optimal quality of service. 

• Acts as a liaison with other operations departments. 

• Monitors departmental compliance with all performance standards, and legal and regulatory requirements. 

• Maintains updated workflows based on current policies and procedures. 

• Participates in quality, regulatory, and account-specific meetings. 

• Responsible for departmental reporting. 

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Minimum Requirements:

• Requires BA/BS in mental health field or an AA in Nursing with related psychiatric nursing experience and a minimum of 5 years of behavioral healthcare experience And a minimum of 3 years managed care experience; or any combination of education and experience, which would provide an equivalent background. 

• Requires current, active, unrestricted license in a mental health field as either a RN, PhD, LCSW, LICSW (as applicable by state law and scope of practice), MHC, LPC, etc. to practice as a health professional within the scope of licensure in the United States.

Preferred Skills, Capabilities and Experiences:

• Minimum 2 years of experience in UM and CM.

• Minimum 1 year of leadership experience is highly preferred. 

• Master’s Degree preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

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. Unless 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 and Influenza. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

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 elevancehealthjobssupport@elevancehealth.com for assistance.

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.