Utilization Management Rep 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 is remote and the pay rate is $20-$24 depending on experience. The Outreach Care Specialist II is responsible for ensuring that member treatment plans are effectively implemented and to proactively enhance health outcomes while meeting quality objectives. This role involves managing moderately complex cases, coordinating care, and identifying opportunities for process improvements to better serve our members. Ideal candidates are proactive, compassionate professionals with strong coordination, communication, and problem-solving abilities. and related duties as assigned.

This position is currently completely remote. This is a long term temporary assignment.

Essential Duties And Responsibilities

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

Care Coordination

• Coordinate follow-up care for members, including scheduling appointments and enrolling members in appropriate health programs.
• Assess member compliance with medical treatment plans through telephone outreach or on-site visits.
• Identify barriers to treatment plan compliance and collaborate with case management and providers to resolve them.
• Recommend modifications to treatment plans and determine the need for additional services in conjunction with healthcare providers.
  
  

Quality Improvement

• Identify and recommend process improvements that impact quality goals, with a focus on optimizing member health outcomes.
• Coordinate the identification and referral of members to local, state, or federally funded programs to address unmet needs.
• Coach members on strategies to reduce health risks and promote healthier lifestyles.
  
  

Documentation And Reporting

• Prepare detailed reports to document case progress and compliance updates, ensuring accurate and timely communication with relevant parties.
• Establish and maintain strong relationships with agencies as outlined in the appropriate contracts.
  
  

Training And Leadership

• Serve as a preceptor for new associates, providing guidance and training to ensure they are equipped to succeed in their roles.
• Participate in or lead cross-functional projects, contributing to the continuous improvement of team processes and member care.
  
  

Education And Experience Requirements

• Requires a high school diploma and a minimum of 3 years of related experience; or any combination of education and experience which provides an equivalent background.
• Certified Nurse Assistant (CNA) or Certified Medical Assistant (CMA) certification, and/or a BS/BA degree in a related field is preferred.
• Bilingual candidates are preferred, as this enhances our ability to serve diverse member populations.
  
  

Physical Requirements

• Possible prolonged periods of sitting at a desk and working on a computer.
• Standard hours of work Monday through Friday, 8:00 am – 5:00 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, where 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.