Behavioral Health Care Manager II

Behavioral Health Care Manager II We are currently hiring for the Maryland Behavioral Health Administrative Services Project!

ATHENA Consulting is an award-winning staffing firm serving state and local governments. Our mission is to make lives better! We make our Clients' Lives Easier by engaging and supporting our clients and partnering with them to be the most knowledgeable staffing partner. We make our Employees' Lives Better by identifying and cultivating their talents and matching these talents with our customers' needs. ATHENA places a high value on customer service, accountability and getting the job done.

POSITION SUMMARY

This

FULL-TIME

position ranges from $32.00-$34.00 per hour, depending on experience, this position is remote but you must be licensed in Maryland. The Behavioral Health Care Manager II (ABA Specialist) is responsible for managing behavioral health utilization management (UM) activities focused on Applied Behavior Analysis (ABA) services for children and adolescents. This role reviews autism spectrum disorder and other developmental behavioral health treatment requests to determine medical necessity, appropriate level of care, and compliance with established clinical guidelines and contractual requirements. The Behavioral Health Care Manager II conducts telephonic and written reviews, evaluates ABA treatment plans, performs care coordination activities, and collaborates with providers, members, and internal stakeholders to ensure access to medically necessary, quality behavioral healthcare in a cost-effective manner. The position requires strong clinical judgment, expertise in ABA treatment modalities, and the ability to manage complex cases while maintaining compliance with regulatory and managed care requirements, and other duties as assigned.

This position is remote.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

• Perform utilization management reviews for Applied Behavior Analysis (ABA) services using established clinical criteria and guidelines.
• Review requests for autism spectrum disorder and other developmental behavioral health services to determine medical necessity and appropriate levels of care.
• Conduct telephonic and written reviews of treatment requests, ensuring compliance with contractual obligations and utilization management standards.
• clinical judgment and ABA expertise to evaluate treatment plans, progress reports, and authorization requests.
• Assess member needs and coordinate care planning activities related to ABA services.
• Monitor treatment progress and collaborate with providers, caregivers, and interdisciplinary teams to support positive member outcomes.
• Facilitate appropriate utilization of health plan benefits and community-based resources.
• Identify barriers to care and recommend interventions that support effective treatment delivery.
• Refer complex or high-risk cases to Peer Reviewers when required.
• Serve as a clinical resource to other Behavioral Health Care Managers regarding ABA treatment modalities, clinical guidelines, and utilization management processes.
• Provide consultation and support on challenging cases and authorization determinations.
• Accurately document case reviews, assessments, determinations, and care management activities within designated systems.
• Utilize software applications to compile, analyze, and report utilization and case management data.
• Maintain timely and thorough documentation in accordance with organizational policies and regulatory requirements.
• Participate in interdepartmental and intradepartmental teams, projects, and initiatives designed to improve quality, efficiency, and member outcomes.
• Maintain knowledge of ABA clinical practices, utilization management guidelines, managed care regulations, and applicable state and federal requirements.
• Ensure compliance with all licensure requirements, accreditation standards, and organizational policies.
• Related job duties as assigned.

Education and Experience Requirements:

• Current, active, unrestricted Board Certified Behavior Analyst (BCBA) certification required.
• Current Maryland Licensed Behavior Analyst (LBA) credential required.
• Current Maryland licensure, if applicable and required by state regulations.
• Minimum of three (3) years of clinical experience practicing as a BCBA.
• Experience working with children and adolescents required.
• Experience with Applied Behavior Analysis (ABA) comprehensive and focused treatment modalities required.
• Prior utilization management experience preferred.
• Prior managed care experience preferred.
• Strong clinical assessment, analytical, problem-solving, and decision-making skills.
• Excellent oral, written, and interpersonal communication skills.
• Proficiency with computer applications and documentation systems

Physical Requirements:

• Due to the comprehensive training requirements of this position, no planned time off will be approved during the first 90 days of employment, except as required by applicable law.
• Possible prolonged periods of sitting at a desk and working on a computer.
• Standard hours of work Monday through Friday, 8:00 am - 6:00 pm.

Successful ATHENA employees will display the following characteristics:

• You strive to be the best in your field currently and in the future.
• You like to make your employer look good.
• You find solutions, w others only see problems.
• You are proactive, you make and meet commitments, and you perform your duties exceedingly well.
• You are aware of the employer's needs at all times and are well-versed in what you personally and ATHENA can offer them as a whole.
• You have the ability to work with diverse, integrated, deliverable-driven teams to accomplish the larger mission.

The benefits of working for ATHENA include a full Benefit package:

• Support from a team of professionals committed to making your life better.
• 19 days of PTO.
• 12 paid holidays, 13 paid holidays during election years.
• Merit / COLA increases.
• Flex time allowed, during the same week.
• Medical, dental and vision insurance.
• Medical and dependent flexible spending account.
• Pet insurance.
• Mass transportation benefit for the Maryland and Washington, D.C. area.
• 401k with a generous employer match.
• Easy to use employee self-serve HR portal.

The statements in this Job Posting are intended to describe the general nature and minimum level of work required. The content should not be construed as a complete list of all duties, responsibilities, and skills required to meet the criteria for this position. Upon request, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Application for employment is not intended to and does not create a contract or offer of employment and if hired, employment with the company is on an at-will basis and could be terminated at the will of either party.

ATHENA Consulting LLC does not discriminate in hiring based on federally protected classifications to include but not limited to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status, marital status or other characteristics protected by law. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities.