Nashville, Tennessee

Description

SHIFT: Day Job

SCHEDULE: Full-time

Your Talent. Our Vision. At Amerigroup, a proud member of the Anthem, Inc. family of companies focused on serving Medicaid, Medicare and uninsured individuals, it’s a powerful combination.  It’s 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.   

Behavioral Health Care Manager I or II Job Family
LOCATION: Must have TN license and reside in TN; preferably within a commutable distance to an Anthem office

The BH Care Manager (UM) job 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.  
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 following UM Clinical Guidelines and contract.
•    Refers cases to Peer Reviewers as appropriate.
•    Performs psychiatric and substance abuse utilization review management to monitor provider assessment, coordination, implementation, and evaluation services to promote quality member outcomes and effective use of health benefits. 
 

Qualifications

Minimum Qualifications for Both Levels
Requires a Master’s degree in social work, counseling, or a degree in nursing and 3 years of clinical experience providing treatment to individuals with complex psychiatric and or substance use disorder diagnosis in an inpatient or outpatient setting; or any combination of education and experience which would provide an equivalent background. 
Requires Current active unrestricted license to practice as an RN LCSW LPC LMFT LAPSW LMSW or Clinical Psychologist within the scope of licensure in Tennessee

Minimum Qualifications for Level II
All of the above and
Experience in utilization management
Experience in managed care

Preferred Experience for both Levels
•    Experience working on multiple computer platforms simultaneously
•    Excellent typing skills


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.

Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s 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. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.

Nashville, Tennessee

If you’re a reserve or veteran member of the military, we foster a welcoming environment that’s dedicated to honoring your service and helping you achieve your career goals. Veterans of Anthem — one of our Business Resource Groups — partners with our Talent Acquisition teams to maximize career offerings for you and your family members, striving to help you transition to civilian service and grow your career at the same time. 

Join Anthem's Military and Veteran Talent Network: https://anthemcareers.ttcportals.com/pages/military 

WE ARE HIRING

Anthem, Inc. is currently seeking military veterans and military spouses with operations experience.  Whether your experience is hands-on as an operational specialist or in operational leadership, Anthem wants to have an impact on your career and professional growth by speaking with you about their career opportunities.

If you are interested in learning more, check out Anthem's current open positions to the right for more information and to apply today!

Not sure where to start?  Send RecruitMilitary Success Manager, Taylor Groves, your questions at taylor.groves@recruitmilitary.com 

 

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