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Managed Care Coordinator (US)

Anthem Blue Cross & Blue Shield

Anthem Blue Cross & Blue Shield

Richmond, VA, USA · Framingham, MA, USA · Arlington, VA, USA · Wilson, NC, USA · Chesapeake, VA, USA · Chesapeake, VA, USA · Roanoke, VA, USA · Roanoke, VA, USA · Alexandria, VA, USA · Alexandria, VA, USA · Norfolk, VA, USA · Norfolk, VA, USA · northampton, uk
Posted on Thursday, May 18, 2023

Position Title:

Managed Care Coordinator (US)

Job Description:

Managed Care Coordinator

Location: WFH – BUT WITH SOME TRAVEL TO CLIENTS OR PATIENT 30%

Must reside in the state of Virginia.
Candidates are regionally based and should be prepared to travel as clinically necessary
.

Monday-Friday 8am-5pm EST

A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive employee assistance program, work/life support, specialty programs for autism and depression, and insightful analytics to improve the delivery of care.

The Managed Care Coordinator is responsible for performing telephonic or face-to-face history and program assessments using a tool with pre-defined questions for the identification, evaluation, coordination, and management of member's program needs.

How you will make an impact:

  • Responsible for performing case management telephonically and/or by home visits within the scope of licensure for members with behavioral health and substance abuse or substance abuse disorder needs.
  • Primary duties may include but are not limited to: Uses appropriate screening criteria knowledge and clinical judgment to assess member needs.
  • Conducts assessments to identify individual needs and develops care plan to address objectives and goals as identified during assessment.
  • Monitors and evaluates effectiveness of care plan and modifies plan as needed.
  • Supports member access to appropriate quality and cost-effective care.
  • Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers.

Minimum Requirements:

  • Requires BA/BS degree and a minimum of 1 year of experience working directly with people related to the specific program population or other related community-based organizations; or any combination of education and experience which would provide an equivalent background.
  • Specific education and years and type of experience may be required based upon state law and contract requirements.
  • Travel may be required.

Preferred Qualifications:

  • BA/BS degree field of study in health care related field preferred.
  • Experience in case management and telephonic and/or in person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders preferred.
  • QMHP certification or MA/MS in social work, counseling, or a related behavioral health field preferred.

Job Level:

Non-Management Non-Exempt

Workshift:

1st Shift (United States of America)

Job Family:

MED > Care Coord & Care Mgmt (Non-Licensed)

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

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.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.