Behavioral Health Care Manager I (3rd Shift -After Hours)- Bilingual

Behavioral Health Care Manager I (3rd Shift - After Hours) - Bilingual

Location : Durham, NC and Winston Salem, NC

Work Shift : 11PM 7AM (EST). Every other weekend commitment includes working two 12-hour shifts from 8 AM to 8 PM on both Saturday and Sunday. (Weekly Hours : 40). Team members are required to work on holidays as part of a rotating schedule.

The Behavioral Health Care Manager I (3rd Shift - After Hours) is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.

How you will make an impact :

• 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 in accordance with UM Clinical Guidelines and contract.
• Refers cases to Peer Reviewers as appropriate.
• Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.

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 experience with facility-based and / or outpatient 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 LCSW LMSW LMHC LPC, LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required. Licensure is a requirement for this position. However, for states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met : performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.

Preferred Skills, Capabilities and Experiences : Previous experience in case management / utilization management with a broad range of experience with complex psychiatric / substance abuse cases preferred. Bilingual in Spanish is highly preferred. Utilization Management experience is preferred. Previous crisis hotline is preferred.

Job Level : Non-Management Exempt

Workshift : 3rd Shift (United States of America)

Job Family : MED >

Licensed / Certified Behavioral Health Role

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.

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.