Behavioral Health Care Manager II

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.

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.

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.
• Apply 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…