Behavioral Health Care Manager II

Anticipated End Date:

2025-09-11

Position Title:

Behavioral Health Care Manager II

Job Description:

Shift: Monday – Friday; 8:00am – 5:00pm EST

Location: Virtual; within 50 miles of New York, New Hampshire, Connecticut, or Maine Elevance Health Pulse Point offices  

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.

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.
• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

For candidates working in person or virtually in the below location(s), the salary* range for this specific position is $71,820 to $112,860

Locations: New York

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company.  The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

* The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sol