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Anthem, Inc.

BH Care Manager Lead - ABA Required - Metairie preferred but can also work in Baton Rouge, LA office - 136486

Anthem, Inc. - Metairie, LA

Anthem, Inc. is the nation's leading health benefits company serving the needs of approximately 40 million medical members nationwide.Your Talent. Our Vision. At Healthy Blue, 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.   $1500 Sign on Bonus for this role: BH Care Manager Lead – ABA Required - Metairie, LA office preferred but can also work in Baton Rouge, LA office.  Responsible for managing requests for outpatient professional behavioral health benefits for applied behavioral analysis and functional treatment assessments through telephonic or written review. Primary duties may include, but are not limited to:
Uses appropriate clinical screening criteria, behavioral health 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 Utilization Management (UM) Clinical Guidelines and contract. Refers cases to Peer Reviewers as appropriate. Performs review of comprehensive diagnostic evaluations, treatment plans and functional assessments, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes to optimize member health benefits, and promoting effective use of health benefits and community resources. Performs care coordination activities on behalf of assigned case load such as educating on health plan ABA (Advanced Behavioral Analysis) benefits and analysis, attending member case conferences, health plan rounds and quality meetings, coordinating member appointments, collaborating with attending providers to develop a multi-disciplinary care plan taking in to account both the physical, social and behavioral needs of the member and etc. Assists with more complex cases, and will participate in inter and intradepartmental teams, projects and initiatives. Oversees the productivity report and may act as a leadership role in the manager’s absence. Serves as a Subject Matter Expert to the department leaders, state partners and health plan executive leadership. Some travel required.  Qualifications:
Requires MS or MA in social work, counseling, nursing or related behavioral health field; 5 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 as an RN, LCSW, LMSW, LMHC, LPC, LMFT, or clinical Psychologist, to practice as a health professional within the scope of licensure in the state of Louisiana required. Previous experience with ABA (Advanced Behavioral Analysis) required. ABA certified preferred (BCaBA, BCBA, BCBA-D, RBT). Previous experience in case management/utilization management with a broad range of experience with complex psychiatric/substance abuse cases required. Prior managed care experience required. Leadership or supervisory experience strongly preferred. Previous experience with reading, analyzing, and communicating/presenting medical data strongly preferred. Excellent management and organization skill preferred.  Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at EOE. M/F/Disability/Veteran. 

14 days 10 hours ago

Anthem, Inc.


BH Care Manager Lead - ABA Required - Metairie preferred but can also work in Baton Rouge, LA office - 136486 Anthem, Inc. - Metairie, LA, United States


Location: Metairie, LA

Company Profile:
The company was formed when WellPoint Health Networks Inc. and Anthem, Inc. merged in 2004 to become the nation's leading health benefits company. The parent company originally assumed the WellPoint, Inc. name at the time of the merger. In December 2014, WellPoint, Inc. changed its corporate name to Anthem, Inc. The Anthem brand is built on a foundation of trust – it’s the name consumers are most familiar with as a trusted health care partner through our affiliated health plans. Anthem, Inc. is one of the largest health benefits companies in the United States. Through its affiliated health plans, Anthem companies deliver a number of leading health benefit solutions through a broad portfolio of integrated health care plans and related services, along with a wide range of specialty products such as life and disability insurance benefits, dental, vision, behavioral health benefit services, as well as long term care insurance and flexible spending accounts. Headquartered in Indianapolis, Indiana, Anthem, Inc. is an independent licensee of the Blue Cross and Blue Shield Association serving members in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia and Wisconsin; and specialty plan members in other states.