Vacancy caducado!
Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and 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. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health care companies and a Fortune Top 50 Company. BH Case Manager II- South CarolinaResponsible for performing field-based and telephonic case management within the scope of licensure for members with behavioral health, physical health, and/or substance use disorder needs.Note: field work is currently on-hold due to COVID-19; a combination of telephonic outreach and Webex video chatting is being used to connect with members and providers. This opening will be located in the following area: South Carolina - this includes the following territory: Lexington, Richland, Sumter, and Kershaw counties. Remote. Up to 70% field work is required. You may be asked to come into the office for occasional meetings. This is once field work has resumed and local offices have re-opened. Primary duties may include, but are not limited to: Completes face-to-face visits with the member in the home, hospital, and other community settings, such as doctor's offices, treatment centers, etc. Responds to more complex cases and account-specific requests. Uses appropriate screening criteria, knowledge, and clinical judgment to assess members’ needs. Conducts clinical assessments to identify individual needs and develops a member-centric 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 member and collaborates with providers. Identifies members at high risk for complications and coordinates care in conjunction with the member and the health care team. Support members with chronic illness, co-morbidities, and/or disabilities, to insure cost-effective and efficient utilization of health benefits, with consideration of social determinants of health. Establishes short and long term goals in collaboration with the member, caregivers, family, natural supports, and providers. Identifies members that would benefit from an alternative level of care or other waiver programs. Assists in problem-solving with providers and the health care team. Serves as a resource to other behavioral health and physical health case managers. Participates in cross-functional teams, projects, and initiatives.Qualifications MS or MA in social work, counseling, related behavioral health field, or a degree in nursing. 3- 4 years of clinical experience in social work / counseling with a broad range of experience with complex psychiatric or substance use disorder treatment. Or any combination of education and experience, which would provide an equivalent background. Current active, unrestricted license as an RN, LCSW, LMHC, LPC, LMSW, LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in South Carolina required. Previous experience in case management and face-to-face telephonic coaching with members, with a broad range of complex psychiatric, substance abuse, and/or medical disorders. Managed care experience preferred. Experience in health coaching and motivational interviewing techniques preferred.Home visit experience is strongly preferred.Problem solving mentality. Great written and verbal communication. Proficient in Microsoft Office. Computer literate. Proficient typing skills. Must live within the Lexington, Richland, Sumter, and Kershaw areas of SC.Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and has been named a 2019 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. REQNUMBER: PS36832
Vacancy caducado!