Quality Manager leading quality systems and assurance teams at Nestlé Health Science. Ensuring compliance with FDA regulations while supporting staff development and continuous improvement.
About the role
- Behavioral Health Care Manager II managing psychiatric and substance abuse treatment health benefits virtually for Elevance Health. Requires a master’s degree and significant experience in the field.
Responsibilities
- managing psychiatric and substance abuse disorder facility-based and outpatient professional treatment health benefits through live telephonic or written review
- assesses member needs to ensure access to medically necessary behavioral healthcare in a cost-effective setting
- refers cases to Peer Reviewers as appropriate
- performs psychiatric and substance abuse disorder assessment coordination implementation case planning monitoring and evaluating
- assists with more complex cases and may participate in inter and intradepartmental teams projects and initiatives
Requirements
- MA/MS in social work counseling or a related behavioral health field or a degree in nursing
- minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse treatment
- current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA LMFT or Clinical Psychologist
- 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
- expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
Job title
Job type
Experience level
Salary
Degree requirement
No Education Requirement
Location requirements
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