Anthem, Inc.
Description
SHIFT: Day Job
SCHEDULE: Full-time
Your Talent. Our Vision. At Beacon Health Options, a proud member of the Anthem, Inc. family of companies, 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. For more than 30 years, Beacon Health Options has changed the way people live with behavioral health conditions. Today, we are the undisputed leader in behavioral health management, serving 37 million people across all 50 states. At Beacon, our mission is to help people live their lives to the fullest potential. Beacon 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.
Manager Behavioral Health Clinical Services Location: Remote Works hours: 2 openings; day shift and evening shift. Some weekends may be required.
The Manager Behavioral Health Clinical Services is responsible for managing the clinical operations department. Manages the delivery of quality care management, clinical utilization and referral services.
Primary duties may include, but are not limited to: • Reviews for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply criteria and render certification decisions that are within the scope of practice that is relevant to the clinical areas under review. • Identifies areas for quality improvement and implements QI activities. • Interfaces with internal and external customers to ensure optimal quality of service. • Acts as a liaison with other operations departments. • Monitors departmental compliance with all performance standards, and legal and regulatory requirements. • Maintains updated workflows based on current policies and procedures. • Participates in quality, regulatory, and account-specific meetings. • Responsible for departmental reporting. • Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Qualifications
Requirements: • Requires BA/BS in mental health field or an AA in Nursing with related psychiatric nursing experience and minimum of 5 years of behavioral healthcare experience and minimum of 3 years managed care experience; or any combination of education and experience, which would provide an equivalent background. • Requires current, active, unrestricted license in a mental health field as an RN, PhD, LCSW (as applicable by state law and scope of practice), MHC, LPC, etc. to practice as a health professional within the scope of licensure in applicable states or territory of the United States. Preferred: • Minimum of 1 year leadership experience.
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.
Anthem, Inc. has been named as a Fortune 100 Best Companies to Work For®, is ranked as one of the 2020 World’s Most Admired Companies among health insurers by Fortune magazine, and a 2020 America’s Best Employers for Diversity by Forbes. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran. Anthem promotes the delivery of services in a culturally competent manner and considers cultural competency when evaluating applicants for all Anthem positions.
REQNUMBER: PS60600-Florida