AddressDescription
Location: The ideal candidate will live within 50 miles or a 1-hour commute each way of one of our Mason, Oh, Cincinnati, Oh or Columbus, Oh Elevance Health PulsePoint locations.
This position will take part in Elevance Health's hybrid workforce strategy, which includes virtual work and 1-2 days in the office per week.
**Candidate must have active Ohio state license**
The Manager Behavioral Health Clinical Services is responsible for managing the clinical operations department. Manages the delivery of quality care management, clinical utilization and referral services.
How you will make an impact:
Reviews for medical appropriateness psychiatric/substance abuse cases utilizing professional knowledge to apply criteria and render certification decisions that are within the scope of practice that is relevant to the clinical areas under review.
Identifies areas for quality improvement and implements QI activities.
Interfaces with internal and external customers to ensure optimal quality of service in-person and in a virtual environment.
Acts as a liaison with other operations departments.
Monitors departmental compliance with all performance standards, and legal and regulatory requirements.
Maintains updated workflows based on current policies and procedures.
Participates in quality, regulatory, and account-specific meetings.
Responsible for departmental reporting. Hires, trains, coaches, counsels, and evaluates performance of direct reports.
Minimum Requirements:
Requires BA/BS in mental health field or an AA in Nursing with related psychiatric nursing experience and minimum of 5 years of Behavioral Healthcare experience and minimum of 3 years managed care experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Requirements:
Minimum of 1 year leadership experience preferred. Requires current, active, unrestricted license in a mental health field as an RN, PhD, LCSW/LISW, LMHC, LPC, and LMFT licensure in the state of Ohio .
Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Who We Are
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.
How We Work
At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.
