Case Consult Manager Therapy Services

Anticipated End Date:

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Job Description:

JR155004 Case Consult Manager Therapy Services

CareBridge Health is a proud member of the Elevance Health family of companies, within our Carelon business. CareBridge Health exists to enable individuals in home and community-based settings to maximize their health, independence, and quality of life through home-care and community based services.

Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions (when indicated), providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development.

The Case Consult Manager Therapy Services is responsible for managing a team of therapy service specialists in conducting multidisciplinary case consults.

How you will make an impact:

• Manages the appropriate and consistent administration of plan benefits to assess medical necessity, out of network services, and appropriateness of services to ensure staff is applying appropriate medical policies, clinical guidelines, plan benefits, and/or scripted algorithms within scope of licensure.

• Oversees adherence to medical policy and member benefits in providing therapy services that are medically appropriate, high quality, and cost effective.

• Ensures staff utilizes the applicable medical policy and industry standards, interprets benefits accurately, and directs members to appropriate providers.

• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Minimum Requirements:

• Requires graduate of a college level program in physical therapy or occupational therapy and minimum of 5 years of clinical experience and minimum 1 year leadership experience; or any combination of education and experience, which would provide an equivalent background.

• Current active unrestricted license as a physical therapist, occupational therapist, physical therapist assistant, or occupational therapist assistant in applicable state(s) required."

Preferred Skills, Capabilities and Experiences:

• Previous experience in case consultations or roles that engage with health plans is essential.

• Must possess excellent verbal and written communication skills, enabling effective interactions with diverse stakeholders.

• Ability to leverage technology effectively in daily operations.

• Demonstrated ability to take strong initiative and exhibit leadership qualities.

• Proven track record of managing, mentoring, and coaching a team to achieve organizational goals.

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Workshift:

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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.

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 and Influenza. 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.com for assistance. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws, including, but not limited to, the Los Angeles County Fair Chance Ordinance and the California Fair Chance Act.