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Licensed Therapist UM(LPC,LCSW,LMFT)

MHMR Tarrant
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Job Description:

  • REMOTE
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Pay is determined by relevant experience, work history, education and internal equities. As part of our Diversity, Equity, and Inclusion practices, MHMR offers the maximum compensation for candidates based on their experience, education and internal equities of the agency. This practice removes biases in compensation and assist hires and/or promotions on pay equity in their appropriate position(s) at MHMR.
Starting Pay Rate: 27.00
I) Job Purpose
The UM Reviewer makes authorization determinations, applying guidelines and requirements relevant to the program and funding sources. The UM Reviewer also identifies utilization trends, training needs and systemic issues that enhance or impede service delivery.
II) Essential Functions
A) The UM Reviewer makes authorization determinations, applying guidelines and requirements relevant to the program and funding sources. The UM Reviewer also identifies utilization trends, training needs and systemic issues that enhance or impede service delivery.
Performance Standards:
  1. Reviews assessments and/or other requests for services for timeliness, completeness and accuracy within two business days of availability.
  2. Communicates in a timely manner with assessors and their supervisory staff, UM Manager and other relevant parties regarding authorization status.
  3. Performs clinical review of requests for services for persons with special circumstances/ needs to ensure that all necessary and feasible accommodations will be made, including the use of the clinical override process.
B) Make authorization determinations for service providers not employed by MHMR Tarrant.
Performance Standards:
  1. Reviews requests for services and supporting clinical documentation within two business days, requesting additional information as needed.
  2. Creates and distributes Letters of Authorization to designated service provider and referring staff within one business day of authorization determination.
C) Evaluates the adequacy, appropriateness and quality of service provided in accordance with TRR-UM Guidelines, current Performance Contract and other applicable regulations and funding sources.
Performance Standards:
  1. Conducts prospective, concurrent and retrospective reviews as needed to establish need for services and to identify outliers and trends.
  2. Consults with providers regarding identified outliers and trends.
  3. Notifies UM Manager of significant trends or outliers.
D) Ensures adverse determination decisions comply with the current performance contract and other applicable standards.
Performance Standards:
  1. Notifies individuals requesting/receiving services of adverse determinations, including information on how to file an appeal or fair hearing, according to applicable regulations and requirements.
  2. Manages appeal notifications and appeal requests in a timely manner according to established procedures.
E) Ensures individuals with benefits provided through Managed Care Organization (MCO) receive services appropriate to their Level of Care.
Performance Standards:
  1. Completes, submits, and tracks Service Request Forms (SRF) to MCO within two days of authorization determination.
  2. Monitors internal and external sources to ensure authorization of services is provided by MCO for individuals who begin or change coverage.
F) Collaborates with other internal and external functions, such as Quality Management, Financial Services, Information Systems and service providers, in the use of data and delivery of services to improve consumer experience and provider practice.
Performance Standards:
  1. Coordinates with internal and external functions regarding individual situations and systemic issues that affect the quality, effectiveness and timeliness of service delivery and/or administrative oversight.
  2. Collaborates in planning, projects and operational initiatives when appropriate.
G) Reviews Flex Fund requests for compliance with UM-TRR Guidelines, current Performance Contract and local requirements, as assigned.
Performance Standards:
  1. Ensures Flex Fund requests have sufficient documentation to support need and determination of appropriate use of funds, including communicating with requesting program for additional information as needed.
  2. Coordinates with other staff involved in administrative processing of Flex Fund requests to facilitate timely payment.
  3. Monitors Flex Fund expenditures and notify staff charged with MH budgeting responsibilities.
H) Provides consultation and training with internal staff and external groups as appropriate.
Performance Standards:
  1. Responds to requests for training in a timely manner.
  2. Identifies and communicates training needs to UM Manager, Clinical Supervisors and others, as appropriate.
  3. Provides ongoing education and consultation with assessors and their supervisors regarding authorization issues.
  4. Identifies opportunities to provide resources and other supports to service providers, developing and implementing processes as assigned.
I) Coordinates with other UM staff to ensure timely and accurate completion of assigned tasks.
Performance Standards
  1. Communicates routinely with peers regarding identified problems and practices.
  2. Participates in staff meetings to identify problems and their solutions.
  3. Coordinates time away from office with peers to ensure effective coverage is maintained.
J) Assumes additional responsibilities and performs special projects, as assigned by supervisor or designee, requesting assistance as needed.
Performance Standards:
  1.  Exhibits willingness to assume additional duties not specified in this job description.
  2.  Consults with supervisor regarding issues requiring clarification, planning or decision.
  3. Completes assigned projects in a timely manner.
K) Maintains training and licensure compliance.
Performance Standards:
  1. Successfully completes MHMR Tarrant initial and refresher training.
  2. Participates in professional development activities for to enhance competency.
  3. Renews license(s) as required and maintains credentialed status.
L) Maintains proficiency in computer software applications specific to Utilization Management functions.
Performance Standards:
  1. Completes requisite computer training within established timeframe and demonstrates ongoing proficiency as needed.
M) Produces positive outcomes as a result of interaction with others.
Performance Standards:
  1. Interacts with clients, other staff, the MHMR Tarrant organization and other organization(s) in a manner which promotes positive outcomes for the employee, the client(s), other staff, their supervisor(s), the MHMR Tarrant organization and other organization(s).
  2. Uses channels of communication prescribed by Agency Operating Procedures, established ”chain of command”, laws, regulations, codes of ethics, professional standards, supervisory instructions, or other legitimate codifying entities in order to bring client and system problems to the attention of the appropriate authority.
  3. Has no more than three episodes per calendar year in which clients, other staff, the MHMR Tarrant organization and other organization(s) have had negative outcomes as a result of the employee’s interactions with them.
N) Performance standards are performed as applicable with MHMR’s We CARE values “We Connect People in Our Community. We Provide Access to Services. We Link People to Resources. We Empower People.”
O) Perform other job duties or responsibilities as requested or assigned.
III) Knowledge of Laws, Regulations, Policies/Procedures, Skills, and Abilities
  • Texas Laws Related to Mental Health
  • Medicaid Rehabilitative Services Rules/Regulations
  • Texas Administrative Codes regarding Mental Health Services
  • Texas Health and Safety Code regarding Mental Health Services
  • CARF Standards
  • AC Standards MHMRTC Policies and Procedures
  • Ability to develop and maintain productive working relationships with agency staff and external service providers.
  • Ability to negotiate and manage conflict diplomatically.
  • Strong advocacy and monitoring abilities.
  • Advanced skills in written and verbal communication.
  • Proficient and skilled in word processing and information systems, particularly the use of Windows software applications, Microsoft Office applications, CMBHS, CMHC, MCO, WebCARE, TMHP, myAvatar.
  • Ability to work in a team and independently.
  • Ability to work with minimal supervision.
  • Strong organizational skills.
  • Ability to work a flexible schedule, in a fast paced, multi-tasking environment.
  • Knowledge of and ability to interpret standards applicable to community centers including: Rules of the Texas Department of State Health Services, Texas Department of Health and Human Services Commission, Commission on Accreditation of Rehabilitation Facilities, and DSHS Performance Contract. 
  • Ability to understand and implement the Utilization Management process as it applies to MHMR Tarrant.
  • Knowledge and application of confidentiality laws.
  • 1 year of behavioral healthcare experience.
  • Experience in applying DSM-IV diagnostic criteria to special population
IV) Internal & External Customer Service
This position requires extensive internal and external contacts. The employee will accomplish this with advanced written and verbal skills. 
V) Travel
This position requires driving to and from locations for work and/and may require overnight traveling. Employees are required to have a license in good standing and be able to be covered by agency liability insurance. If personal vehicle is utilized for work travel, then maintaining personal auto insurance coverage is required.
Job Requirements:

Required Education
Master’s Degree
Defined Education
Health or Human Services, Behavioral Science
Required Experience
Two (2) years
Defined Experience
Health or Human Services, Academic or Research Setting
Substitutions
None
Preferences
None
Required License(s)
Fully licensed and in good standing in the state of Texas as a Licensed Professional Counselor (LPC), Licensed Clinical Social Worker (LCSW), or Licensed Marriage and Family Therapist (LMFT).
Valid Texas driver’s license with an acceptable driving record.
Must provide license and official documentation of all educational attainment i.e. Transcript/Degree/Certificate.
Required Supervisory Experience
0 year(s)
Testing Requirements
Pre-employment tests including drug and TB Screening, Physical Exam including balance and lift test.
Satori Alternatives to Managing Aggression (SAMA)
Lifting Requirements
55 Pounds
All staff are required to participate in agency Emergency Preparedness and Environmental Safety programs and may be assigned by their departments as a key/essential staff level function during critical events or for the purpose of sustaining business continuity.
This position may require temporary or permanent re-assignment to any MHMR Tarrant facility as determined by program needs and /or the Division/Director.
Assigned work hours may change as the needs of the agency change.
The functional Title of this position may change as the needs of the agency change.
All work will be complete within the scheduled work hours. All non-exempt (hourly) employee are expected to clock In and out for each work shift, no work done should be done off the clock.
Prior approval from supervisor is required for all Paid Time Off (PTO) and Overtime.
MHMR reserves the tight to change, and to or eliminate a position as it deems appropriate.
Employment is at will, as well as agency needs may change.
Agency dress code is to be followed at all times.
Physical on-site presence, including regular attendance and punctuality is an essential function of this position. Any change or adjustments to your assigned work schedule or shift hours must be approved by your supervisor in advance.
Our Benefits:
Our total rewards program offers benefits* to full time employees beginning 1st of the month following hire date including but not limited to:
• Comprehensive healthcare options (Medical, Dental, and Vision)
• Life insurance and additional supplemental accident and hospitalization plans
• 401a match and 457 deferred compensation plans
• Paid vacation and holidays; varied flexible work environment locations
• Annual tuition reimbursement program
• Student Loan Forgiveness
• Professional development programs and training
• And more…..
Insurance eligibility:
• Full time employees begin 1st of the month following hire date
• Market driven positions (full time or part time) begin immediately after hire date
• Select part time market driven positions are eligible for most insurance plans
• Substitute status jobs are not eligible for benefits
For more information, click here.
Additional Information
*MHMR of Tarrant County (“MHMR”) and its affiliates and subsidiaries have an internal recruiting department. MHMR may supplement that internal capability from time to time with assistance from temporary staffing agencies, placement services, and professional recruiters herein after referred to collectively as “Recruiters"). Recruiters are hereby specifically directed NOT to contact MHMR employees directly in an attempt to present candidates – MHMR recruiting team or other authorized MHMR personnel must present ALL candidates to hiring managers. For more information please visit our website www.mhmrtc.org