Crisis Management Representative

How you will make an impact:

• Manage incoming calls
• Determine contract and benefit eligibility
• Provide authorization for inpatient admission, outpatient precertification, prior authorization, and post service requests
• Obtains intake (demographic) information from caller
• Conducts a thorough radius search in Provider Finder and follows up with provider on referrals given
• Refers cases requiring clinical review to a nurse reviewer; and handles referrals for specialty care
• Processes incoming requests, collection of information needed for review from providers, utilizing scripts to screen basic and complex requests for precertification and/or prior authorization
• Verifies benefits and/or eligibility information
• May act as liaison between Medical Management and internal departments
• Conducts clinical screening process

Minimum Requirements:

Level II :

• Requires HS diploma or equivalent and a minimum of 2 years customer service experience in healthcare related setting and medical terminology training; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities and Experiences

• Bachelor's degree is STRONGLY preferred
• Crisis line or mental healthcare experience very strongly preferred
• Experience working on a phone/text/chat platform completing assessments preferred
• Master’s Degree preferred
• De-escalation skills
• Motivational interviewing or similar skills
• Strong oral, written and interpersonal communication skills
• Problem-solving skills

*** For candidates working in person or remotely in the below locations, the salary* range for this specific position is $15.96 to $35.30 ***

Locations: California; Colorado; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY

In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

• The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.