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Elevance Health

Sells health insurance and pharmacy benefits

Special Programs Case Manager Lead - 1915i/Intellectual and Developmental Disabilities Team

Mental & Behavioral HealthConfirmed live in the last 24 hours
Full-timeNorth Carolina, USAIn-person

About the Job

Requirements

  • An MS/MA in social work, counseling, or a related behavioral health field, or a degree in nursing, and at least 7 years of clinical experience in social work counseling with broad experience in complex psychiatric and substance abuse or substance abuse disorder treatment; equivalent combinations of education and experience are accepted.
  • An active, current, and valid license as an RN, LCSW (as applicable by state law and scope of practice), LMHC, LPC (as allowed by applicable state laws), LMFT, or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable U.S. states or territories is required.
  • North Carolina residency is required.
  • Candidates must reside within a reasonable commuting distance of a posting office unless an accommodation is granted as required by law.

Responsibilities

  • Coordinate operations and workflows related to case management activities in support of specialty programs, such as foster care.
  • Coach staff and perform case management telephonically and/or by home visits within the scope of licensure.
  • Manage overall healthcare costs for the designated population through integrated physical and behavioral health case management and whole-person health.
  • Manage the most complex cases and provide support to Special Programs case managers.
  • Conduct assessments to identify individual needs.
  • Develop comprehensive care plans addressing objectives and goals identified during assessment; support member access to appropriate, quality, cost-effective care and modify plans as needed.
  • Coordinate internal and external resources to meet members’ identified needs for integrated physical and behavioral whole-person care.
  • Coordinate social determinants of health to meet member needs and incorporate them into care planning.
  • Work closely with state agencies.
  • Maintain knowledge of the system-of-care philosophy and of effective community-based services and supports for people with or at risk for mental health or other challenges and their families, organized into a coordinated network.
  • Build partnerships with designated populations and their families, and address cultural and linguistic needs to help them function better at home, in the community, and throughout life.
  • Evaluate health needs and identify applicable services and resources with members and their families.
  • Provide patient education and other important information, reconcile medications, identify community resources, and assist with arranging follow-up care.
  • Facilitate health rounds with other clinical professionals to support whole-person health.
  • Lead and work on specialty projects and initiatives as needed.
  • Assist with process-improvement activities.
  • Train and mentor staff, perform case/chart audits, and ensure departmental compliance.

Desired Qualifications

  • Experience working with specialty populations.
  • Clinical experience in social work counseling across a broad range of complex psychiatric/substance abuse and/or medical disorders.

About the Company

Elevance Health

Sells health insurance and pharmacy benefits

Elevance Health is one of the largest U.S. health insurers, covering people through employers, individual plans, Medicare and Medicaid. It is the Blue Cross Blue Shield licensee in 14 states, where it sells plans under the Anthem name, and it runs government plans under the Wellpoint name in other markets. Its Carelon division runs the CarelonRx pharmacy benefit manager and sells behavioral health, care management and other services to its own plans and outside clients. Elevance earns most of its revenue from premiums paid by employers, members and government programs, plus fees for Carelon services. The company is headquartered in Indianapolis, Indiana.

Company size
10,001+
Company stage
IPO
Headquarters
Indianapolis, IN
Founded
1944

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