Behavioral Health Care Manager II

Anticipated End Date:

2025-10-27

Position Title:

Behavioral Health Care Manager II

Job Description:

Behavioral Health Care Manager II

A proud member of the Elevance Health family of companies, Carelon Behavioral Health, 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. 

Virtual - This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Alternate locations may be considered.

Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law.

Work Shift Hours: Monday through Friday, 8AM - 5PM (EST) business hours with some weekends based upon organizational/business needs.

The Behavioral Health Care Manager II is responsible for managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review.

How you will make an impact:

• Uses appropriate screening criteria 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 UM Clinical Guidelines and contract.

• Refers cases to Peer Reviewers as appropriate.

• Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources.

• Will serve as a resource to other BH Care Managers.

• Assists with more complex cases and may participate in inter and intradepartmental teams projects and initiatives.

Minimum Requirements:

• Requires MA/MS in social work counseling or a related behavioral health field or a degree in nursing, and minimum of 3 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 such as RN LCSW LMSW LMHC LPC LBA (as allowed by applicable state laws) LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required.

• Licensure is a requirement for this position. However, for states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision.

• 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.

Preferred Skills, Capabilities, and Experiences:

• Behavioral Health and/or substance abuse experience strongly preferred.

• Previous managed care experience preferred.

• MCG and ASAM experience strongly preferred.

• Ohio Medicaid utilization management experience preferred.

Job Level:

Non-Management Exempt

Workshift:

Job Family:

MED > Licensed/Certified Behavioral Health Role

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

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