Amerigroup, a proud member of the WellPoint family of companies, is focused on serving Medicaid, Medicare and uninsured individuals and families. We improve access to quality health care for the financially vulnerable, seniors and people with disabilities.
Here, you can do work that matters and offers opportunities for personal and professional growth. Together, our associates are transforming health care with trusted and caring solutions.
Our Behavioral Health Care Manager is responsible for managing psychiatric and chemical dependency facility-based and outpatient professional treatment through telephonic or written review.
Primary duties may include, but are not limited to:
- Uses appropriate screening criteria, knowledge and clinical judgment assesses patient needs and assures that medically necessary treatment is provided in a quality, cost-effective manner.
- Follows guidelines to refer cases to Medical Advisors as appropriate.
- Utilizes skills and knowledge in psychiatric and chemical dependency assessment, negotiation, coordination, implementation, case planning, monitoring, and evaluating to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
- Ensures member access to medical necessary, quality behavioral healthcare in a cost effective setting according to contract.
Requires a MS in social work, counseling or a related behavioral health field; at least 1 year of experience with facility-based and/or outpatient psychiatric and chemical dependency treatment; or any combination of education and experience, which would provide an equivalent background. Previous experiences in case management/utilization review preferred. Current unrestricted license as an RN, LCSW, LICSW, LPC (as allowed by applicable state laws), LMFT, LBA, or Clinical Psychologist (CP) required.
Candidates can be located in Houston, Austin, El Paso, Lubbock, Dallas/Ft. Worth, or San Antonio.
WellPoint is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine, and is a 2013 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us at www.wellpoint.com/careers. EOE. M/F/Disability/Veteran.