WellPoint is the nation's leading health benefits company serving the needs of approximately 28 million medical members nationwide. 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.
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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.