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Behavioral Health Care Manager KY Medicaid

Company Name:
UniCare Life & Health Insurance Company

job
Description
Anthem Blue Cross and Blue Shield is a proud member of the WellPoint family of companies. At Anthem, we are working together to transform health care with trusted and caring solutions.

Bring your expertise to our innovative culture where you will have the opportunity to make a difference in people's lives, and to take your career further than you can imagine.

Location: Louisville, KY
Hours: Monday-Friday 8 hour shift between 8:00 a.m. - 5:00 p.m
Manages psychiatric and chemical dependency facility-based and outpatient professional treatment through telephonic or written review serving our
kentucky
Medicaid member population. Primary duties may include, but are not limited to:
Using appropriate screening criteria, knowledge and clinical judgment assesses patient needs and assures that medically necessary treatment is provided in a quality, cost-effective manner.
Follows guidelines to refer cases to Medical Advisors as appropriate.
Utilizes skills and knowledge in psychiatric and chemical dependency assessment, negotiation, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
Ensures member access to medical necessary, quality behavioral healthcare in a cost effective setting according to contract.
Job Qualifications
Requires a Masters degree in social work, counseling or related behavioral health field, and current, unrestricted Kentucky license as a Licensed Clinical Social Worker in relevant state, LPC (Licensed Professional Counselor) designation, Clinical Psychologist, or Registered Nurse.
Requires 3-5 years experience with facility-based and/or outpatient psychiatric and chemical dependency treatment, or any combination of education and experience, which would provide an equivalent background.
Inpatient psychiatric treatment experience strongly preferred.
Previous experiences in utilization review preferred.
Intermediate to higher level skills in Word - required, Excel is a plus! Strong PC skills - ability to navigate between multiple systems and learn new systems easily a definite asset.
_WellPoint is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at_ _. EOE. M/F/D/V.___
Once an offer is accepted, all external applicants are subject to a background investigation and if appropriate, drug testing. Offers of employment shall be contingent upon passing both the background investigation and drug testing (if required).
Current WellPoint associates: All referrals must be submitted through the formal associate referral process on WorkNet. Official guidelines for the associate referral program can be found in My HR.

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