Behavioral Health - Case Manager I Job at Elevance Health (Virtual (Must live in Tidewater Region, Virginia))

Behavioral Health Tech (BHT)-Residential

Join Southwest Behavioral Health Services – The Leading Behavioral Health System...

Location

United States , Payson

Salary:

Not provided

Southwest Behavioral Health Services

Expiration Date

Until further notice

Requirements

Minimum requirement consists of a 21-year age
A High School Diploma/GED and six months of full-time Behavioral Health experience/integrated health experience
OR A related Associate’s degree and six weeks of full-time Behavioral Health/integrated health experience
OR A non-related Associate's degree and one year of full-time behavioral health/integrated health experience
OR A related bachelor’s degree
OR A non-related bachelor's degree plus six months of relevant experience in behavioral health
MVR clearance required
Must have fingerprint clearance issued by the Arizona Department of Public Safety or be eligible to receive upon hire

Job Responsibility

Provide screening, assessment, treatment planning, life skills, pre-vocational training, related documentation, case management, crisis intervention, individual and/or group counseling services to seriously mentally ill consumers in a residential environment
Responsible for contributing to and creating a recovery-based environment

What we offer

3 weeks of PTO your 1st year of employment, with increased accruals after continued service
10 paid holidays
Low-cost medical, dental and vision insurance, short-term/long-term disability and life insurance for employees
40% company match up to a 10% deferral into your SB&H retirement account
Career Development – Benefit from our culture of internal promotion
Reduce your tuition costs with our tuition reimbursement program & discount degree programs
Employee Assistance Program, Health & Wellness and much more

Fulltime

Integrated Care Manager

Responsible for promoting continuity of care through a collaborative process tha...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
Associate’s Degree in general field of study or Post High School Nursing Diploma or Master’s Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D
Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN
Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications
Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC).

Job Responsibility

Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan
Answer a diverse and high volume of health insurance related customer calls on a daily basis
Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc
Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests
Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines
Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
Maintain complete and accurate records per department policy
Demonstrate ability to apply plan policies and procedures effectively

Fulltime

Case Manager, Registered Nurse

Remote case manager position working intensely as a telephonic case manager with...

Location

United States , Remote

Salary:

54095.00 - 155538.00 USD / Year

CVS Health

Expiration Date

Until further notice

Requirements

5+ years’ experience as a Registered Nurse
1+ year of experience in a hospital setting
Active, unrestricted RN license in state of residence
Willingness to receive multi-state/compact privileges
1+ years' experience documenting electronically using a keyboard
1+ years' current or previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health/Substance Abuse or Maternity/Obstetrics experience

Job Responsibility

Work as a telephonic case manager with patients and their care team
Application and/or interpretation of applicable criteria and clinical guidelines
Assess benefits and/or member's needs to ensure appropriate administration of benefits
Incorporate strategies designed to reduce risk factors and barriers
Address complex health and social indicators which impact care planning
Consult with supervisor and others in overcoming barriers
Utilize case management processes in compliance with regulatory requirements
Utilize motivational interviewing skills for member engagement
Identify and escalate member's needs appropriately
Actively reach out to members to collaborate/guide their care

What we offer

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation programs
Weight management programs
Confidential counseling
Financial coaching
Paid time off
Flexible work schedules

Fulltime

Behavioral Health Medical Director

The Behavioral Health (BH) Medical Director leverages clinical expertise to prov...

Location

United States

Salary:

189600.00 - 237000.00 USD / Year

Personify Health

Expiration Date

Until further notice

Requirements

MD or DO degree and 5+ years of direct clinical patient care experience post residency or fellowship including behavioral health environments
Current and ongoing Board Certification in psychiatry by the American Board of Psychiatry and Neurology (ABPN) required
Additional Board Certification in Child and Adolescent Psychiatry or Addiction Medicine
A current and unrestricted license in the state of California and willing to obtain additional license(s)
No current sanction from Federal or State Governmental organizations, and able to pass credentialing requirements
Minimum 5 years of Utilization Review or Hospital experience required
Minimum 3 years of compliance related experience preferred
Managed Care experience preferred in utilization review and case management
Expertise in behavioral health case management, utilization review and telehealth delivery
Ability to design and evaluate behavioral health programs, integrating evidence-based practices and holistic wellbeing approaches

Job Responsibility

Oversee and participate in behavioral health case management, including utilization review, telephonic care, and urgent response coordination for behavioral health and substance use disorder needs
Conduct reviews for medical necessity for prior authorization, continued stay, and post-service claims, applying medical policy, guidelines, and current research
Integrate behavioral health screening and interventions within physical health case management programs, utilizing standardized tools (e.g., PHQ2, PHQ9) and ensuring appropriate referrals
Support and monitor virtual behavioral health services, ensuring access, privacy, and continuity of care for all age groups, including children, teens, and adults
Supervise and provide clinical oversight for residential and outpatient behavioral health programs, including partial hospitalization and intensive outpatient services, with an emphasis on family engagement and comprehensive discharge planning
Lead the development and implementation of comprehensive behavioral health strategies, including program design, staff education, and quality improvement initiatives
Maintain compliance with national guidelines (e.g., MCG, InterQual, specialty college recommendations) and regulatory requirements (federal, state, ERISA) specific to behavioral health
Oversee the negotiation and implementation of cost management strategies to affect quality outcomes, reflecting data in monthly case management reviews
Participate in grievance and appeals processes, including escalated behavioral health issues
Collaborate with the VP of Care Management to establish work procedures and processes that support company and departmental standards, procedures, and strategic directives

What we offer

Comprehensive medical and dental coverage through our own health solutions
Mental health support and wellness programs designed by experts who get it
Flexible work arrangements that fit your life
Retirement planning support to help you build real wealth for the future
Basic Life and AD&D Insurance plus Short-Term and Long-Term Disability protection
Employee savings programs and voluntary benefits like Critical Illness and Hospital Indemnity coverage
Professional development opportunities and clear career progression paths
Mentorship from industry leaders who want to see you succeed
Learning budget to invest in skills that matter to your future
Unlimited PTO policy

Parttime

Community Support Worker

Coordinate and provide services and resources to individuals/families necessary ...

Location

United States , Albuquerque

Salary:

22.49 - 33.74 USD / Hour

UNM Hospitals

Expiration Date

Until further notice

Requirements

Bachelor's Degree in Related Discipline
1 year directly related experience
CPR for Healthcare/BLS Prov or Prof Rescuers w/in 30 days
Valid New Mexico Driver's License
UNM Vehicle Operator's Permit w/in 60 days

Job Responsibility

Coordinate and provide services and resources to individuals/families necessary to promote rehabilitation, recovery, and resiliency
Identify and address the strengths and barriers in the recovery process
Support the individual and the family in crisis situations
Provide personalized interventions to enhance decision-making
Work with children at risk, adults with severe mental illness, individuals with substance abuse, and co-occurring disorders
Adhere to core expectations of the Patient Centered Medical Home/Specialty Practice
Work to eliminate barriers to access culturally competent medical services
Collaborate with medical providers and community resources
Facilitate development of life skills in daily living, interpersonal coping, socialization, and community functioning
Plan for professional growth

What we offer

Receive 17% Weekday Nights, 26% Weekend Nights and 15% Weekend Day shift differentials

Fulltime

Integrated Care Manager - Adult

Responsible for promoting continuity of care through a collaborative process tha...

Location

United States , Phoenix

Salary:

Not provided

Blue Cross Blue Shield of Arizona

Expiration Date

Until further notice

Requirements

2 year(s) of experience in full-time equivalent of direct clinical care to the consumer
Associate’s Degree in general field of study or Post High School Nursing Diploma or Master’s Degree in a behavioral health field of study (i.e., MSW, MA, MS, M.Ed.), Ph.D. or Psy.D
Active, current, and unrestricted license to practice in the State of Arizona (or an endorsement to work in Arizona) as a behavioral health professional such as LCSW, LPC, LISAC LMFT, or licensed psychologist (Psy.D. or Ph.D.), OR an active, current, and unrestricted license to practice nursing in either the State of Arizona or another state in the United States recognized by the Nursing Licensure Compact (NLC) as an RN
Within 4 years of hire as a Care Manager employee must hold a certification in case management from the following certifications
Certified Case Manager (CCM), Certified Disability Management Specialist (CDMS), Case Management Administrator, Certified (CMAC), Case Management Certified (CMC), Certified Rehabilitation Counselor (CRC), Certified Registered Rehabilitation Counselor (CRRC), Certified Occupational Health Nurse (COHN), Registered Nurse Case Manager (RN, C), or Registered Nurse Case Manager (RN,BC)
Intermediate PC proficiency
Intermediate skill in use of office equipment, including copiers, fax machines, scanner and telephones
Intermediate skill in word processing, spreadsheet, and database software
Maintain confidentiality and privacy
Advanced and current clinical knowledge

Job Responsibility

Assess and collect data related to the member from all care settings. Interview and collaborate with case-related providers, member and family to implement the care plan
Answer a diverse and high volume of health insurance related customer calls on a daily basis
Explain to customers a variety of information concerning the organization’s services, including but not limited to, contract benefits, changes in coverage, eligibility, claims, BCBSAZ programs, provider networks, etc
Analyze medical records and apply medical necessity criteria and benefit plan requirements to determine the appropriateness of benefit requests
Present status reports on all cases to the manager/supervisor and, when indicated, to the medical director
Consult and coordinate with various internal departments, external plans, providers, businesses, and government agencies to obtain information and ensure resolution of customer inquiries
Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines
Maintain all standards in consideration of state, federal, BCBSAZ, URAC, and other accreditation requirements
Maintain complete and accurate records per department policy
Demonstrate ability to apply plan policies and procedures effectively

Fulltime

Worklife Resource Consultant - Medicare

The Worklife Resource Consultant is part of the Worklife Team and provides educa...

Location

United States , Remote

Salary:

21.10 - 49.08 USD / Hour

CVS Health

Expiration Date

Until further notice

Requirements

1+ year(s) of experience working with the elderly and/or adults with disability populations in a capacity that specifically includes completing resource needs assessments, educating, researching and referring to appropriate community resources
1+ year(s) experience in social work, social services, or case management field
Private, confidential workspace free from distractions
professional, camera-ready work environment available at all times
Excellent verbal and written communication skills
Reliable wired internet connection (minimum 400 Mbps download, 10-20 Mbps upload)
no DSL or cellular internet
Comfortable conducting video chats, virtual calls and using digital communication tools
Bachelor's degree required in Social Work or a social services/health related field

Job Responsibility

Provides education about community resources
Conducts resource needs assessment
Provides community and/or national referrals for childcare, elder/adult care, and basic/everyday needs
Provides Worklife consultation and informational services to members and plan sponsors
Assesses resource needs, proposes options and research/screens potential community service providers
Provides resource referrals and educates individuals on how to use resources
Documents member interactions and research/case fulfillment
Works in inbound and outbound call center environment
Completes outbound phone calls and research
Staffs an online chat platform

What we offer

Affordable medical plan options
401(k) plan with matching company contributions
Employee stock purchase plan
Wellness screenings
Tobacco cessation and weight management programs
Confidential counseling
Financial coaching
Paid time off
Flexible work schedules
Family leave

Fulltime

Lead Social Worker

Regional Lead Social Workers are an important part of our Care Teams, supporting...

Location

United States , Chicago

Salary:

51256.00 - 111351.00 USD / Year

CVS Health

Expiration Date

January 31, 2026

Requirements

Minimum of 2 years of case coordination/care management experience
LCSW/LMSW (or state equivalent licensure) required
Demonstrates supportive and welcoming attitude toward our patient population of older and disabled adults
An eagerness to build relationships with patients, their families, and the communities we serve
A problem-solving orientation with a flexible and positive attitude
Bilingual fluency preferred-depending on community served
Proficient PC skills
US work authorization

Job Responsibility

Building and cultivating relationships with our patients and community partners
Leading social work and community health worker interviewing and hiring initiatives for the region
Assisting regional leadership team with expanding social work and community health worker services
Providing training and orientation to new social workers and community health workers
Clinical case consultation support to care management staff
Conducting soft audits of care plans and chart documentation
Administrative support on care management driven modules and technology
Providing LCSW supervision to staff
Working as a liaison between organizational initiatives and regional care management staff
Assisting regional care management staff in aligning and carrying out organizational goals and metrics

What we offer

Paid vacation and sick time
Generous 401K match with immediate vesting
Health benefits
Affordable medical plan options
Employee stock purchase plan
No-cost wellness screenings
Tobacco cessation and weight management programs
Confidential counseling and financial coaching
Flexible work schedules
Family leave

Fulltime

Behavioral Health - Case Manager I

Elevance Health

Location:
United States of America , Virtual (Must live in Tidewater Region, Virginia)

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
January 05, 2026

Expiration:
January 05, 2026

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Job Description:

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Job Posted:January 05, 2026

Expiration:January 05, 2026

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