Anthem BH Case Mgr I - Texas - PS5002 in Apple Valley, California

BH Case Mgr I - Texas - PS5002

Location: United States

Field: Medical

Requisition #: PS5002

Post Date: Apr 24, 2018

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 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.

Location : Texas (Houston, Grand Prairie, El Paso, Austin, Lubbock, San Antonio) *Remote opportunity (within 30 miles of an Amerigroup office preferred) is allowable at manager’s discretion after the ideal candidate has successfully completed a minimum of 90 days of in-office training.

The BehavioralHealth Case Manager I will provide services to Texas Medicaid members with a focus on behavioral health and substance abuse issues. We are looking for highly motivated independent thinkers to utilize various modalities for engaging members and providers to provide clinically and cost effective care. This position may include all of the following: field visits with members, facilities and providers, utilization management, project management, and telephonic outreaches. Our team assists with discharge planning, improving community tenure of our members, and coordinating member care within AGP internal departments and member’s community treatment teams.

Primary duties may include, but are not limited to:

  • Conduct extensive assessmentson member’s treatment utilizing member, member supports, providers, andelectronic records to determine how best to address member needs.

  • Create care plans to addressmember needs as identified during assessment

  • Collaborate with outpatientproviders and inpatient facilities in implementing the care plan

  • Evaluate and monitor memberneeds and adjust care plan as clinically appropriate

  • Face-to-face visits withmember, member supports, and providers to assess, monitor, and coordinatecare

  • Utilization review withfacilities, as needed, in order to coordinate inpatient and outpatientcare and to support member’s access to quality and cost effective care

  • Community reach-outs toproviders to establish connections and build resources and support member’saccess to quality and cost effective care

  • Community reach-outs toproviders to establish connections and build resources

  • Serve as a resource to othercase managers

  • Participate in cross-functionalteams, projects and initiatives

  • Lead, initiate and implementcreative solutions to barriers members are facing to receiving effectivecare

  • Develop expertise in specifiedareas of business needs for individual development and growth

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 please visit us at EOE.M/F/Disability/Veteran.

  • Current active unrestrictedlicense as an LCSW, LPC, LMFT, or RN, to practice as a healthprofessional within the scope of licensure in state of Texas

  • 3 years of clinical experiencein social work, counseling with broad range of experience with complexpsychiatric and substance abuse or substance abuse disorder treatment

  • Experience using electronicdocumentation

  • Knowledge of Microsoft office(word, excel, and outlook)

  • Experience in case managementand telephonic coaching with members with a broad range of complexpsychiatric/substance abuse and/or medical disorders required

  • Reliable transportation andauto liability required for potential field work

  • Flexibility in being assignedto various programs or projects as assigned by management that are subjectto change

  • Experience in health coachingand motivational interviewing techniques preferred

  • Bilingual (Spanish) preferred